Aging clinical and experimental research
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Multicenter Study Observational Study
Diabetes mellitus, frailty and prognosis in very elderly patients with acute coronary syndromes.
The magnitude of the association between diabetes (DM) and outcomes in elderly patients with acute coronary syndromes (ACS) is controversial. No study assessed the prognostic impact of DM according to frailty status in these patients. ⋯ About 40% of elderly patients with ACS had previous known DM diagnosis. The association between DM and outcomes was different according to frailty status.
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Frailty is a multidimensional geriatric syndrome associated with functional loss. The Senior Chef (SC, nutrition) and SAYGO (strength and balance exercise) programmes are well accepted among older adults but the impact of each, or a combination of both, on the frailty syndrome in pre-frail older adults is unknown. ⋯ This trial is designed to be a real world rigorous assessment of whether the two intervention strategies can prevent progression of frailty in older people. If successful, this will generate valuable information about effectiveness of this nutrition and exercise strategy, and provide insights for their implementation.
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Various factors have been shown to affect the rehabilitation outcome of hip fractured patients. Considering the decrease in muscle mass with aging and its impact on mobility, we hypothesized that a relationship exists between hand grip strength and rehabilitation outcome. ⋯ Hand grip strength is independently associated with rehabilitation outcome in post-acute frail hip fractured patients. Initial screening for hand grip strength on admission may help identify patients who require an intensive resistance exercise program.
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Randomized Controlled Trial
Older persons with signs of frailty in a home-based physical exercise intervention: baseline characteristics of an RCT.
Increasing the level of physical activity among persons with signs of frailty improves physical functioning. There is a lack of long-term supervised physical exercise intervention studies including a validated definition of frailty. ⋯ Our participants showed marked physical frailty without major disabilities. The severity of frailty seems to be associated with impaired functional independence and HRQoL.
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The Charlson Comorbidity Index (CCI) is the most widely used assessment tool to report the presence of comorbid conditions. The Barthel index (BI) is used to measure performance in activities of daily living. We prospectively investigated the performance of CCI or BI to predict length of hospital stay (LOS), mortality, cardiovascular (CV) mortality and rehospitalization in unselected older patients on admission to the emergency department (ED). We also studied the association of CCI or BI with costs. ⋯ CCI and BI independently predict LOS, mortality, CV mortality, and rehospitalization in unselected older patients admitted to ED.