Journal of the American Medical Directors Association
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Review Meta Analysis
Frailty as a Predictor of Alzheimer Disease, Vascular Dementia, and All Dementia Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.
To perform a systematic search of the literature for currently available evidence on frailty as a predictor of dementia and to conduct a meta-analysis to synthesize the pooled risk estimates among community-dwelling older people. ⋯ This systematic review and meta-analysis suggests that frailty was a significant predictor of Alzheimer disease, vascular dementia, and all dementia among community-dwelling older people. Frail women may have a higher risk of incident Alzheimer disease than frail men.
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Malnutrition plays a major role in clinical and functional impairment in older adults. The use of validated, user-friendly and rapid screening tools for malnutrition in the elderly may improve the diagnosis and, possibly, the prognosis. The aim of this study was to assess the agreement between Mini-Nutritional Assessment (MNA), considered as a reference tool, MNA short form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and Nutrition Risk Screening (NRS-2002) in elderly institutionalized participants. ⋯ Functional, psychological, and cognitive parameters, not considered in MUST and NRS-2002 tools, are probably more important risk factors for malnutrition than acute illness in geriatric long-term care inpatient settings and may account for the low predictive value of these tests. MNA-SF seems to combine the predictive capacity of the full version of the MNA with a sufficiently short time of administration.
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Functional status is associated with patient outcomes, but is rarely included in hospital readmission risk models. The objective of this study was to determine whether functional status is a better predictor of 30-day acute care readmission than traditionally investigated variables including demographics and comorbidities. ⋯ Readmissions are currently used as a marker of hospital performance, with recent financial penalties to hospitals for excessive readmissions. Function-based readmission models outperform models based only on demographics and comorbidities. Readmission risk models would benefit from the inclusion of functional status as a primary predictor.
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To assess the role of frailty in predicting death and incident disability in older adults with type 2 diabetes mellitus. ⋯ Frailty is an important risk factor for death and disability in older adults with diabetes, supporting the recent recommendations that frailty status should be routinely assessed in these patients.
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Age-related muscle loss (sarcopenia) and increased fat mass (obesity) may contribute to chronic disease. Multimorbidity needs more complex health care and is associated with an elevated risk of mortality, disability, and poor quality of life. Sarcopenia and obesity together may be more closely associated with multimorbidity than either sarcopenia or obesity alone. However, a possible multimorbidity link with sarcopenic obesity is unknown. Thus, we aimed to investigate the association of sarcopenic obesity and multimorbidity in Korean adults. ⋯ In conclusion, we found that sarcopenia and obesity are independently associated with the risk of multimorbidity, but with these conditions combined, sarcopenic obesity has a greater risk of multimorbidity.