BACKGROUND

Malnutrition is a component of frailty syndrome characterized by weakness, poor nutritional status, and reduced cognitive function. Frailty has been recognized to adversely affect post-cardiovascular surgery outcomes, with studies primarily in the elderly. To date, there are no published Philippine data on malnutrition and frailty in cardiac surgery patients.

Malnutrition and frailty were assessed preoperatively in 111 adult patients undergoing cardiovascular surgery from October 2020 to February 2021. Nutrition Risk Screening (NRS) tool and Clinical Frailty Scale (CFS) were used for assessment, respectively. Their in-hospital postoperative outcomes were then observed.

There were 57 patients (51%) diagnosed with malnutrition, 26 (23%) of whom were also frail. Advanced age, rheumatic heart disease, heart failure, and chronic kidney disease were significantly higher in the malnutrition and frail group. After multivariate analysis, mortality rate (odds ratio [OR], 7.8; 95% confidence interval [CI], 1.45-41.91; P = 0.017), prolonged hospitalization (OR, 5.96; 95% CI, 2.14-16.53; P = 0.001), mechanical ventilation (OR, 7.56; 95% CI, 1.81-31.62; P = 0.006), and nosocomial infections (OR, 13.57; 95% CI, 4.41-41.76; P < 0.001) were found higher in patients with malnutrition and frailty.

Evaluation of nutrition and frailty status using NRS and CFS was helpful in predicting postoperative outcomes. With a significant number of this population having malnutrition and frailty, there is a need to strengthen clinical pathways on perioperative nutrition and rehabilitation with the possibility of improving cardiovascular surgery outcomes.

Objectives: This study aims to describe the sociodemographic and clinical profile of working and retired staff and faculty age 55 years and older in an academic community living in Laguna, Philippines; to determine the proportion of participants with Type 2 Diabetes Mellitus (T2DM); and to describe the nutritional and frailty status of working and retired participants with T2DM. Methods: The study utilized a cross-sectional study design. The participants are current employees and retired faculty and staff of an academic community living in Bay and Los Baños, Laguna, Philippines. Stratified random sampling according to working status and gender was utilized. Participants with T2DM were determined and assessed based on their nutritional and frailty status using the comprehensive geriatric assessment (CGA), laboratory analysis, and mini nutritional assessment (MNA). Descriptive statistics were calculated for all continuous and categorical variables measured. Results: A total of 109 participants agreed to participate and completed the CGA, with 93.6% undergone blood extraction for laboratory analysis. The mean age of the participants was 63.7 (±5.8) and 57.8% belonged to the young-old subgroup. There were more working (60.6%) than the retired (39.4%) and more females (61.5%) than males (38.5%). There was a low level of malnutrition (0.9%) in this cohort. However, many had abdominal obesity and elevated low-density lipoprotein (LDL). Low vitamin D was prevalent. Type 2 Diabetes Mellitus was present among 14.7% of participants of which 93.8% were pre-frail and 6.3% were at risk for malnutrition. Conclusion Although malnutrition and frailty were not prevalent among those with T2DM in this cohort, more participants were pre-frail and at risk for malnutrition. There are many opportunities to reduce the risk of malnutrition and frailty in the community. Early screening and interventions are recommended to improve the health and wellbeing of the working and retired participants.
Aged ; Frailty

Frailty ; Heart Failure ; Humans

OBJECTIVES

As the population ages, the likelihood of cancer increases. Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients with advanced cancer. This study aimed to determine whether frailty was strongly associated with emotional distress, particularly anxiety and depression.

This is a single center, cross-sectional, descriptive study using the Geriatric 8 (G8) Frailty Screening Scale and the Hospital Anxiety and Depression Scoring (HADS) Scale.

One hundred five patients (105) were included in the study. Over-all, 86 (81.9%) were frail. Majority of them were female (50, 47.6%), married (57, 54.3%), and were able to graduate college (62, 59.0%). Hypertension (70, 66.7%) and diabetes mellitus (33, 31.4%) were the most common co morbidities. There was significant association between the patients’ functional status (ECOG score) and frailty (p = 0.001). Our results showed that the likelihood of being frail increased by 30% per unit increase in the ECOG score (OR 3.685, CI 1.623 - 8.366). More so, our results showed strong association between frailty, depression & anxiety (p = 0.000 & 0.001, respectively). We also found that the likelihood of being anxious & depressed was 7-times as much for those patients who were frail (OR 7.000, CI 2.132 – 22.981; OR 7.150 (CI 2.406 – 21.246, respectively).

Frailty had a strong association with both anxiety and depression. Frailty, in addition, had a good predictive value for emotional distress. Those who were frail had a 7-time likelihood of being anxious and depressed. Frailty was also associated with functional status. The chances of being frail increased by 30% for every unit increase in the ECOG score.

Introduction: A demographic shift towards population aging is evident worldwide. This presents challenges particularly to low-income and middle-income countries like the Philippines. Understanding perceptions of aging, resilience, vulnerability, and gender identity will help prepare the health care system and social services in addressing the needs of the Filipino older population. Objective: To describe gender identity, perceptions of active aging, successful aging, resilience, and vulnerability among faculty and staff (working, retired) in an academic community in the Philippines. Methods: Survey and focus group discussions were conducted among working and retired faculty and staff aged 55 years old and above. Results, Analysis, and Discussion Almost all respondents had the same gender identity as their biological sex. There were differences in the respondents’ perceptions of active aging and successful aging and in their sources of strength and worries. Compared with retired respondents more working respondents believed that active aging meant being strong and physically active or being involved in sports. Female respondents thought that being socially active in their community and church was indicative of active aging. In contrast, male respondents equated being physically healthy with active aging. More working respondents and females (than retired and male respondents) thought that successful aging meant participating in community-based activities. In terms of vulnerability, differences were noted in the respondents’ sources of strength and worries. In general, retired respondents and female respondents said they got their strength from their grandchildren and from their religion. In contrast, working respondents and male respondents relied on their families for strength. It was also noteworthy that more retired respondents did not have any old agerelated worries compared with working respondents. Female respondents worried about their families while male respondents worried about death. Subjective nuances of being an older working or a retired employee in an academic community surfaced in the FGDs. The importance of context was evident in shaping the informants’ perceptions of active aging and frailty, and in their sources of worries and happiness. Overall, this paper adds to the body of knowledge about aging in the Philippines by studying a group of older Filipinos in an academic community. It showed that particular aspects of Filipino culture such as gender roles, religion, and close family ties permeate one’s life until he or she reaches old age. The results can help academic communities in policy formulation and program development to ensure that their older employees — throughout their life course — can adequately address vulnerability and resiliency needs to achieve active and successful aging.
Humans ; Female ; Male ; Frailty ; Gender Identity ; Philippines ; Aging

OBJECTIVE: To compare the efficacy and safety of different chemotherapy regimens in elderly multiple myeloma (MM) patients with different Frailty scores. METHODS: The clinical data of elderly patients with MM were retrospectively analyzed, including age, treatment regimen, efficacy, adverse reactions, and the Frailty score included in the activity of daily living score, the instrumental activity of daily living scale and the Charlson comorbidity index. The patients were divided into fit group, mediate fit group and frail group according to the scoring standard. The treatment efficiency and adverse reaction rates of elderly MM with different physical conditions treated by different chemotherapy regimens were analyzed. RESULTS: Among the 70 patients, the effective rates of the patients in fit group, the mediate fit group, and the frail group were 79.5%, 81%, and 40%, and the effective rates of the fit patients in double and triple groups were 54.5% and 89.3%, 70% and 90.9% for mediate fit patients, 42.9% and 33.3% for frail patients, the triple regimen in fit patients showed obvious advantages, and the difference showed statistically significant (P<0.05), while the efficacy for mediate patients and frail patients showed no significant difference. During the induction of bortezomib, the incidence of adverse reactions for the patients in the triple group (78.6%) was higher than 67.9% in the double group, and the difference showed no statistically significant (P>0.05).There was no significant difference in the 1-year overall survival rate of the patients and with molecular genetic abnormalities among each groups. CONCLUSION The therapeutic effect is related to the patient's physical condition. For patients with healthy physique, the triple regimen should be used first. For patients with weak physical constitution, the chemotherapy regimen with low drug toxicity should be selected for safety.
Aged ; Bortezomib ; Frailty ; Humans ; Multiple Myeloma/drug therapy* ; Retrospective Studies

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.
Aged ; Humans ; Frail Elderly ; Frailty ; Quality of Life ; Aging ; Sleep

Biomedical Research ; Frailty ; Geriatrics ; Health Policy ; Health Services ; Humans ; Practice Guidelines as Topic ; Singapore

INTRODUCTION: The Asia-Pacific Clinical Guidelines for the Management of Frailty recommended the use of validated measurement tools for identifying frailty. In an effort to contribute to the development of best practice guidelines in frailty identification and measurement, our scoping review aimed to present a summary of published research on this topic among older adults in Singapore. Our findings are important given the need to consider the context of use and the goals of measurement in using validation tools. MATERIALS AND METHODS: We searched PubMed and CINAHL® for articles describing the identification and measurement of frailty among older adults (≥60 years) in Singapore and mined the bibliographies of eligible articles. An article was eligible if it involved empirical research on frailty using a structured frailty definition. We described such articles and the conceptual definitions they used, and summarized their operationalization of frailty. RESULTS: Our search yielded 165 records. After 2-stage screening of titles/abstracts and full-text articles, we retained 32 eligible articles for data extraction and thematic analysis. The extant literature in Singapore includes observational cross-sectional and longitudinal studies and intervention studies across community and tertiary care settings. Eligible articles commonly used the frailty phenotype and the deficit accumulation models in defining frailty, and reported measuring components of physical, cognitive, and/or social frailty. CONCLUSION Our scoping review provided a broad evidence synthesis of the underpinnings of research on frailty identification and measurement in Singapore. Consistently applying standard methods and approaches in frailty identification and measurement can support evidence-based practice and policies in Singapore.
Aged ; Evidence-Based Practice ; methods ; standards ; Frail Elderly ; Frailty ; diagnosis ; Geriatric Assessment ; methods ; Humans ; Singapore

Objective: To identify distinct frailty trajectories in a cohort of nationwide community adults aged 50 years and above, and explore the relationship between frailty trajectories and their socioeconomic characteristics and behavioral factors at baseline survey. Methods: Data were from the three waves of "Global Ageing and Adult Health Research" (SAGE) by World Health Organization in China. The frailty index is generated from 32 items. Group-based trajectory modeling using a censored normal model was conducted to identify the patterns in frailty progression over time. Multinomial logistic regression model was used to examine the effect of socioeconomic status and behavioral factors on the frailty trajectories. Results: A total of 4 303 adults aged 50 years and above with complete data from all three rounds of project were included in the final analysis. Three frailty trajectories were identified: low and stable trajectory (LT) (56.8%), moderately increased trajectory (MT) (34.4%) and highly increased trajectory (HT) (8.8%). The results of the multinomial logistic regression analysis showed that the HT group was more likely to be women (OR=1.88, 95%CI:1.22-2.92) and rural residents (OR=1.87, 95%CI:1.29-2.70) compared with the LT group. In terms of household wealth per capita, there was a clear gradient in ORs, the people with lower household wealth were more likely to be classified in the HT group. Conclusion: This study identified three patterns of progression of frailty trajectories in population aged 50 years and above in China and highlighted that interventions should target those vulnerable populations with rapid progression of frailty.
Adult ; Humans ; Female ; Male ; Frailty/epidemiology* ; China/epidemiology* ; Aging ; Logistic Models ; Social Class