Prevalence and factors influencing slow gait speed among geriatric patients at outpatient clinic of a tertiary care hospital.

BACKGROUND: Slow gait speed (GS) is a marker of functional decline and overall poor health status and could be considered as possible sarcopenia. Early detection with modified treatable causes is likely to lessen adverse health outcomes in older adults. AIMS: The aim of this study is to determine the prevalence of slow GS and related factors of older adults in an outpatient setting of a tertiary care hospital. METHODS: A cross-sectional study of older adults at an outpatient clinic of Internal Medicine Department of a tertiary care hospital was conducted during April 2020 and December 2021. Demographic data were collected including Montreal Cognitive Assessment (MoCA) for cognitive assessment and Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. A 4-m walk test < 1 m/s was defined as slow GS. RESULTS: A total of 198 participants were available for analysis. The prevalence of slow GS was 75.8% (66.2% in men and 81.5% in women). The multivariate analysis showed that age, the presence of cerebrovascular disease (CVA), and MoCA scores were associated with slow GS with adjusted odds ratios of 1.1, 8.8, and 0.9, respectively. CONCLUSIONS: Slow gait speed was frequent among older patients in an outpatient setting indicating of a high prevalence of patients with poor physical performance and impending frailty. Increasing age, presence of CVA, and cognitive decline were associated with slow GS. Interventions concentrating on the amendable factors might help to reduce unfavorable health consequences.

Frailty as a Predictor of Hospitalization and Low Quality of Life in Geriatric Patients at an Internal Medicine Outpatient Clinic: A Cross-Sectional Study.

Frailty is an aging-associated state that increases patients' vulnerability to disease, and can lead to various adverse outcomes. It is classified as either physical frailty alone or physical frailty in combination with cognitive impairment (cognitive frailty). There are currently limited data available regarding the prevalence and adverse outcomes of frailty in Thailand. This was a cross-sectional study aimed at determining the prevalence of physical and cognitive frailty and their effects on hospitalization and quality of life. Participants were older patients who attended an internal medicine outpatient clinic. Frailty was diagnosed using the Thai Frailty Index. The Thai version of the MoCA was used to evaluate cognitive status. Univariate and multivariate analyses were performed to compare adverse outcomes in terms of poor quality of life and history of admission to hospital between patients with frailty and non-frail patients, and among patients with physical frailty, cognitive frailty, cognitive impairment, and robust (non-frail and non-cognitively impaired) patients. We enrolled 198 participants. The prevalence of physical and cognitive frailty was 28.78% and 20.70%, respectively. When compared with non-frail patients, frailty was associated with hospitalization (adjusted OR 3.01, p = 0.002) but was not significantly related to quality of life (adjusted OR = 1.98, p = 0.09). However, physical and cognitive frailty were associated with fair quality of life when compared with normal patients (adjusted OR = 4.34, p = 0.04 and adjusted OR = 4.28, p = 0.03, respectively). The prevalence of frailty-particularly cognitive frailty-was high. Frailty was associated with adverse outcomes in terms of hospitalization and quality of life.

The Prevalence of Low Handgrip Strength and Its Predictors among Outpatient Older Adults in a Tertiary Care Setting: A Cross-Sectional Study.

BACKGROUND: Low muscle strength is linked to several adverse health outcomes. However, there are limited data regarding its prevalence and associated factors in Thai older adults. This study aimed to fill that gap. METHODS: This cross-sectional study was conducted with patients aged ≥ 60 years at the outpatient clinic of the internal medicine department of a tertiary care hospital from April 2020 to December 2021. Patient characteristics were collected, and a handgrip dynamometer was used to measure handgrip strength (HGS). Low HGS was defined according to the 2019 recommendations of the Asian Working Group for Sarcopenia. RESULTS: In total, 198 patients were recruited. The prevalence of low HGS was 51%. Median HGS was 17.8 kg and 27.7 kg in women and men, respectively. Every age per year increase, greater number of medications of any type, and lower Montreal Cognitive Assessment (MoCA) score were independent factors associated with low HGS, with adjusted odds ratios of 1.1, 1.2, and 0.9, respectively. CONCLUSIONS: Low HGS was prevalent among older patients in this setting, indicating a high degree of possible sarcopenia. As there were some modifiable factors associated with low HGS, routine measurement, medication review, and cognitive evaluation are recommended for early diagnosis and management.