1.Co-occurrence of Frailty, Possible Sarcopenia, and Malnutrition in Community-Dwelling Older Outpatients: A Multicentre Observational Study
Siti SETIATI ; Kuntjoro HARIMURTI ; Ika FITRIANA ; Noto DWIMARTUTIE ; Rahmi ISTANTI ; Muhammad Khifzhon AZWAR ; I Gusti Putu Suka ARYANA ; Sri SUNARTI ; Agus SUDARSO ; Dina Aprillia ARIESTINE ; Lazuardhi DWIPA ; Novira WIDAJANTI ; Nur RIVIATI ; Roza MULYANA ; Rensa RENSA ; Yudo Murti MUPANGATI ; Fatichati BUDININGSIH ; Nina Kemala SARI
Annals of Geriatric Medicine and Research 2025;29(1):91-101
Background:
The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients.
Methods:
We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively.
Results:
The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status.
Conclusion
Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.
2.Co-occurrence of Frailty, Possible Sarcopenia, and Malnutrition in Community-Dwelling Older Outpatients: A Multicentre Observational Study
Siti SETIATI ; Kuntjoro HARIMURTI ; Ika FITRIANA ; Noto DWIMARTUTIE ; Rahmi ISTANTI ; Muhammad Khifzhon AZWAR ; I Gusti Putu Suka ARYANA ; Sri SUNARTI ; Agus SUDARSO ; Dina Aprillia ARIESTINE ; Lazuardhi DWIPA ; Novira WIDAJANTI ; Nur RIVIATI ; Roza MULYANA ; Rensa RENSA ; Yudo Murti MUPANGATI ; Fatichati BUDININGSIH ; Nina Kemala SARI
Annals of Geriatric Medicine and Research 2025;29(1):91-101
Background:
The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients.
Methods:
We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively.
Results:
The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status.
Conclusion
Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.
3.Co-occurrence of Frailty, Possible Sarcopenia, and Malnutrition in Community-Dwelling Older Outpatients: A Multicentre Observational Study
Siti SETIATI ; Kuntjoro HARIMURTI ; Ika FITRIANA ; Noto DWIMARTUTIE ; Rahmi ISTANTI ; Muhammad Khifzhon AZWAR ; I Gusti Putu Suka ARYANA ; Sri SUNARTI ; Agus SUDARSO ; Dina Aprillia ARIESTINE ; Lazuardhi DWIPA ; Novira WIDAJANTI ; Nur RIVIATI ; Roza MULYANA ; Rensa RENSA ; Yudo Murti MUPANGATI ; Fatichati BUDININGSIH ; Nina Kemala SARI
Annals of Geriatric Medicine and Research 2025;29(1):91-101
Background:
The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients.
Methods:
We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively.
Results:
The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status.
Conclusion
Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.
4.Delirium after Hemiarthroplasty for Neglected Hip Fracture
Florensius GINTING ; Komang Agung IRIANTO ; Novira WIDAJANTI
Hip & Pelvis 2025;37(4):298-306
Purpose:
Hemiarthroplasty of hip joint is a frequently performed procedure in geriatric patients, especially in cases of trauma.Several risk factors are associated with this surgery, including postoperative delirium, which has been linked to poorer functional recovery, longer hospital stays, and higher short- and long-term mortality rates. The present study aimed to compare the rates and risk factors of postoperative delirium and its correlation with neglected cases in geriatric patients.
Materials and Methods:
This retrospective study was performed at Surabaya Orthopedic and Traumatology Hospital, using a manual medical record database ranging from 2019 to 2023. The study focused on geriatric patients who underwent hemiarthroplasty for hip fracture. Demographic, preoperative, and procedural data were collected and analyzed, followed by a review of postoperative outcomes.
Results:
Out of 219 patients who underwent hip fracture surgery, 23 were neglected cases while 29 cases developed postoperative delirium. Statistical analysis showed no correlation between the neglected cases and the increased incidence of delirium. Several independent risk factors were identified for postoperative delirium, such as age ≥75 years (odds ratio [OR]=7.766, 95% confidence interval [CI]=1.921-31.393), history of dementia (OR=6.768, 95% CI=1.793-25.555), use of general anesthesia (OR=11.600, 95% CI=1.896-70.972), American Society of Anesthesiologists class 3 (OR=3.245, 95% CI=1.215-8.664), and obesity (OR=9.911, 95% CI=2.009-48.947) (all P<0.05).
Conclusion
Patients with neglected hip fractures who underwent hemiarthroplasty did not show higher incidence of postoperative delirium. The risk factors found in this study can be used to determine whether neglected or non-neglected patients are at high risk of postoperative delirium.

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