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1.
Rev Fac Cien Med Univ Nac Cordoba ; 78(1): 9-16, 2021 03 12.
Artigo em Espanhol | MEDLINE | ID: mdl-33787022

RESUMO

Introduction: Frailty is a term used to quantify the physiological age of patients. Higher levels of frailty correlate with higher complications and mortality rates after different surgical procedures. The objective of this work is to evaluate the relationship between frailty and the complications and mortality rates after elective spinal surgeries within 90 days. Material and Methods: A retrospective observational analytical study of patients older than 18 years with elective spine surgery was performed. The following variables were analyzed differentially according to their Modified Frailty Index (mFI) with a cut-off point of 0,18: age, sex, body mass index, ASA score, details of the procedures, length of stay, complications, unscheduled rehospitalizations, reoperations, and mortality within 90 postoperative days. Results: 257 patients were included. Within the 30 complications, 16 occurred in the non-frail group (8%) and 14 in frail patients (24.5%), (p = 0.02). Six complications were infectious in the group of frail patients (10.5%) and 4 in the non-frail patients (2%), (p = 0.009). No significant differences were detected regarding the duration of surgeries, the length of stay or the reoperations, re-hospitalizations or mortality rates. Conclusion: Patients with a modified Frailty Index ≥0,18 who underwent elective spine surgery were 3 times more likely to present complications, particularly, infectious ones.


Assuntos
Fragilidade , Humanos , Complicações Pós-Operatórias , Estudos Retrospectivos
2.
Acute Med ; 20(1): 48-67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33749694

RESUMO

BACKGROUND/OBJECTIVES: A systematic review was conducted to assess if frailty and sarcopenia were associated with poorer outcomes in older adults admitted to an acute medical unit (AMU). METHODS: Eligible studies included older adults with an unplanned admission to an AMU and included a measure of frailty or sarcopenia, completed within 72 hours of admission. Risk of bias was assessed. RESULTS: Of 1659 identified articles, 16 were included (4 on sarcopenia and 12 on frailty). There was significant study heterogeneity. Overall, frailty and sarcopenia were associated with worse outcomes. Targeted interventions appeared to improve outcomes. CONCLUSION: Current evidence suggests some benefit in screening older adults admitted to an AMU for frailty and sarcopenia. However, further studies are required before clinical adoption.


Assuntos
Fragilidade , Sarcopenia , Idoso , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Hospitalização , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
3.
Artigo em Alemão | MEDLINE | ID: mdl-33725737

RESUMO

With patient safety being anesthesiologists' top priority, the focus of preoperative assessment must be to reduce perioperative morbidity and mortality of each patient entrusted to us. Perioperative risk is multifactorial and depends on the extent of surgery and the preoperative condition of the patient.The three main causes of unexpected perioperative death are cardiac arrest, hypoxemia and acute bleeding. Therefore, cardiac and pulmonary risk assessment should cover pre-existing conditions, patient's functional capacity and risk factors associated with the surgical procedure. Specific assessment tools have been developed, are easily accessible and have proven effective in every day clinical practice. Regarding the risk of bleeding, taking a detailed patients' history (including medication) seems to be more suitable to detect mild bleeding disorders than laboratory screening.Functional capacity, defined as the patient's ability to cope with everyday life, gains importance in preoperative risk assessment, as do further factors like deficiencies in nutrition, anaemia, physical capacity, the metabolic status or frailty in the elderly. Prehabilitation strategies reduce perioperative mortality and morbidity by improving functional capacity. These include preoperative nutrition supplementation, physical exercise, correction of iron deficiency and optimized treatment of hyperglycemia.A combination of thorough risk stratification and prehabilitation strategies can improve preoperative conditions and reduce complications in the postoperative period.


Assuntos
Anestesiologia , Fragilidade , Parada Cardíaca , Idoso , Humanos , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios , Medição de Risco , Fatores de Risco
4.
Ann R Coll Surg Engl ; 103(3): 180-185, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645274

RESUMO

INTRODUCTION: The UK has an ageing population with an increased prevalence of frailty in the over 70s. Emergency laparotomy for acute intra-abdominal pathology is increasingly offered to this population. This can challenge decision making and information given to patients should not only be based on mortality outcomes but on relative expected quality of life and change to frailty syndromes. MATERIALS AND METHODS: This was a single site National Emergency Laparotomy Audit (NELA)-based retrospective cohort audit for consecutive cases in the septuagenarian population assessing mortality, length of stay outcome and subjective postoperative functioning. Follow-up was conducted between one and two years postoperatively to determine this. RESULTS: Some 153 patients were identified throughout the single site NELA database. Median age was 79 years with a ratio of 1.7 men to women. Median rate of all-cause mortality was 35.3% at the median follow-up of 19 months. Median time from admission to death was 120 days. Of those who had died by the time of follow-up, significant preoperative indicators included clinical frailty scale (p < 0.0001), preoperative P-POSSUM (mortality). At follow-up, 35% responded to a quality of life follow-up. This revealed a decline in mid-term physical functioning, lower energy, higher fatigue and reduction in social functioning. There was also an increase in pre- and postoperative clinical frailty scale score. CONCLUSION: In the septuagenarian-plus population it is important to consider not only risk stratification with mortality scoring (P-POSSUM or NELA-adjusted risk), but to take into account frailty. Postoperative rehabilitation and careful recovery is paramount. Where possible, during the counselling and consent for emergency laparotomy, significant postoperative long-term deterioration in physical, emotional and social function should be considered.


Assuntos
Emergências , Fragilidade/epidemiologia , Mortalidade Hospitalar , Laparoscopia , Laparotomia , Tempo de Internação , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Fadiga , Feminino , Seguimentos , Idoso Fragilizado , Humanos , Masculino , Estudos Retrospectivos , Reino Unido/epidemiologia
5.
West Afr J Med ; 38(3): 255-267, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33765747

RESUMO

BACKGROUND: Frailty has emerged as an important clinical measurement among older adults because of its negative health outcomes. OBJECTIVE: This study measured the prevalence and factors associated with frailty among older adults aged 60 years and above at a Geriatric Centre in Nigeria. METHODS: In this descriptive cross-sectional study, 971 older adults were recruited consecutively. Data on sociodemographics characteristics and clinical parameters were obtained using an interviewer-administered questionnaire and physical examination performed. The Frailty syndrome and Frailty Index were assessed using the Fried Frailty Criteria (FFC) and Canadian Study of Health and Aging (CSHA) scale respectively. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05. RESULTS: The mean age of the participants was 71.3 (± 7.1) years with a female to male ratio of 2.4:1. Based on FFC scale, 498 older persons (51.3%) had frailty syndrome while only 148 (15.2%) were frail using the CSHA scale. The measure of agreement (Kappa statistics) was 0.22 (p<0001) indicating weak agreement between the two scales. Logistic regression analysis revealed increasing age (OR=1.948 [1.219-3.113]), multiple morbidities (OR= 1.584, [1.177-2.201]), depression (OR= 5.050, [2.501-9.442,]), imbalance or increased risk of fall (OR 1.623, [1.192-2.211,]), and inability to perform IADL (OR= 0.599 [0.535-0.670,]) to be the most significant determinants of frailty syndrome while obesity (OR=0.660, [0.449-0.971]), unusually appeared a deterrent. CONCLUSION: The prevalence of frailty syndrome was high among the older adults. Targeted and timely interventions on the modifiable factors may delay progression into frailty and the eventual negative health outcomes.


Assuntos
Fragilidade , Idoso , Idoso de 80 Anos ou mais , Canadá , Estudos Transversais , Feminino , Idoso Fragilizado , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Avaliação Geriátrica , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Universidades
6.
Medicine (Baltimore) ; 100(9): e25027, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655975

RESUMO

ABSTRACT: The prevalence of obesity as well as cognitive impairment increases with age. Previous studies showed that obesity is associated with an increased risk of cognitive impairment and dementia. Body composition changes occur as part of the aging process; therefore, the assessment of obesity in elderly populations should include body composition as well as body weight. This study investigated the relationship between body mass index (BMI), body composition, and cognitive function in a community-dwelling elderly Korean population.This cohort-based cross-sectional analysis included 2386 elderly participants aged between 70 and 84 years from the Korean Frailty and Aging Cohort Study for 2016 to 2017. To investigate the relationship between body composition and cognitive function in community-dwelling individuals, BMI and body composition, including total and trunk fat mass and fat-free mass, were measured by dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) were used to represent the body composition. A short form of the Korean version of the Consortium to Establish a Registry for Alzheimer disease was used to assess cognitive function. To evaluate the relationship between variables, simple and fully adjusted multivariable analyses were performed using generalized linear regression models.The mean ages were 76.8 years for males and 76.1 years for females. The BMI of male participants was significantly lower than that of females (23.9 ±â€Š2.89 vs 24.7 ±â€Š3.02 kg/m2, P < .001). Among body composition parameters, the differences in FMI (6.44 ±â€Š1.97 vs 9.29 ±â€Š2.3 kg/m2), TFMI (3.68 ±â€Š1.33 vs 5.03 ±â€Š1.43 kg/m2), and FFMI (17.4 ±â€Š1.64 vs 15.3 ±â€Š1.39 kg/m2) were statistically significant. In linear regression analyses, BMI, FMI, and TFMI showed significant positive correlations with mini-mental state examination in the Korean version of the CERAD assessment packet; wordlist memory, recall, and recognition; and frontal assessment battery only in males. The significant positive correlations persisted even after fully adjusting for age, education periods, location of residence, depression, marriage, annual income, presence of diabetes mellitus, dyslipidemia, and hypertension. However, no significant correlations in either sex were observed between FFMI and cognitive functions in the fully adjusted models.In this study, BMI, and fat mass-related indexes including FMI and TFMI showed a positive linear correlation with cognitive functions but not FFMI. Moreover, the findings were significant only in men. Besides the difference between sexes, the results of this study showed a more apparent correlation in fat mass than in fat-free mass that comprises body weight.


Assuntos
Envelhecimento , Composição Corporal , Cognição/fisiologia , Disfunção Cognitiva/epidemiologia , Fragilidade/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/fisiopatologia , Estudos Transversais , Feminino , Fragilidade/psicologia , Humanos , Masculino , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos
7.
Clin Interv Aging ; 16: 415-429, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33692620

RESUMO

Purpose: Older persons have been identified as a vulnerable population with respect to the novel coronavirus outbreak, COVID-19. Aiming to "flatten the curve" a strict Movement Control Order (MCO) was implemented in Malaysia. Older adults with cognitive frailty are prone to physical, cognitive and psychosocial decline. This study aims to compare physical activity patterns, psychological wellbeing and coping strategies of older persons with cognitive frailty in the "WE-RISE" trial (intervention versus control) throughout this period. Materials and Methods: This study was conducted as a sub-analysis of the ongoing "WE-RISE" randomized controlled trial. This study included 42 community-dwelling older adults, aged 60 years and above, with cognitive frailty, stratified into intervention (n=21) and control (n=21) groups who are receiving a multi-domain intervention and usual care, respectively, within the Klang Valley, Malaysia. Phone call interviews were conducted during the MCO period. Physical activity patterns were assessed using International Physical Activity Questionnaire (IPAQ) and Functional Activities Questionnaire (FAQ). Psychological wellbeing was assessed using Flourishing Scale (FS) and General Health Questionnaire (GHQ-12), while the Brief Coping Orientation to Problems Experienced (COPE) assessed coping strategies. Data were analysed descriptively and with independent samples t-test. Results: The WE-RISE intervention group had significantly higher levels of estimated resting energy expenditure (MET) for "walking activity" (I:µ=1723.1±780.7;C:µ=537.4±581.9)(p<0.001), "moderate activity" (I:µ=1422.8±1215.1;C:µ=405.7±746.9)(p=0.002) and "total physical activity" (I: µ=3625.9±3399.3;C:µ=994.6±1193.9)(p=0.002). The intervention group was also significantly more independent in functional activities (µ=1.76±1.73) as compared to the control group (µ=5.57±8.31) (p<0.05). Moreover, significant higher self-perception of living a meaningful life and feeling respected (p<0.05) was demonstrated in regard to psychological well-being in the intervention group. Regarding coping strategies, the intervention group relied significantly on the domains of religion (I:µ=6.43±0.99;C:µ=6.09±1.09)(p<0.05) and planning (I:µ=4.81±0.75; C:µ=4.04±1.28)(p<0.05) whilst the control group relied on humour (C:µ=3.14±1.19; I:µ=2.38±0.74)(p<0.05). Conclusion: Participants of the WE-RISE intervention group were more physically active, functionally independent and had higher self-perceived social-psychological prosperity regarding living a meaningful life and feeling respected; whilst both groups relied on positive coping strategies during the MCO. These results indicate that it is vital to ensure older persons with cognitive frailty remain physically active and preserve their psychosocial wellbeing to be more resilient in preventing further decline during a crisis such as the COVID-19 pandemic.


Assuntos
Adaptação Psicológica , Exercício Físico , Idoso Fragilizado/psicologia , Fragilidade/psicologia , Idoso , Idoso de 80 Anos ou mais , Cognição , Metabolismo Energético , Feminino , Fragilidade/epidemiologia , Humanos , Vida Independente , Entrevistas como Assunto , Estudos Longitudinais , Malásia , Masculino , Pessoa de Meia-Idade , Pandemias
8.
BMC Geriatr ; 21(1): 186, 2021 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731018

RESUMO

BACKGROUND: A large number of studies have explored the association between frailty and mortality among COVID-19 patients, with inconsistent results. The aim of this meta-analysis was to synthesize the evidence on this issue. METHODS: Three databases, PubMed, Embase, and Cochrane Library, from inception to 20th January 2021 were searched for relevant literature. The Newcastle-Ottawa Scale (NOS) was used to assess quality bias, and STATA was employed to pool the effect size by a random effects model. Additionally, potential publication bias and sensitivity analyses were performed. RESULTS: Fifteen studies were included, with a total of 23,944 COVID-19 patients, for quantitative analysis. Overall, the pooled prevalence of frailty was 51% (95% CI: 44-59%). Patients with frailty who were infected with COVID-19 had an increased risk of mortality compared to those without frailty, and the pooled hazard ratio (HR) and odds ratio (OR) were 1.99 (95% CI: 1.66-2.38) and 2.48 (95% CI: 1.78-3.46), respectively. In addition, subgroup analysis based on population showed that the pooled ORs for hospitalized patients in eight studies and nursing home residents in two studies were 2.62 (95% CI: 1.68-4.07) and 2.09 (95% CI: 1.40-3.11), respectively. Subgroup analysis using the frailty assessment tool indicated that this association still existed when using the clinical frailty scale (CFS) (assessed in 6 studies, pooled OR = 2.88, 95% CI: 1.52-5.45; assessed in 5 studies, pooled HR = 1.99, 95% CI: 1.66-2.38) and other frailty tools (assessed in 4 studies, pooled OR = 1.98, 95% CI: 1.81-2.16). In addition, these significant positive associations still existed in the subgroup analysis based on study design and geographic region. CONCLUSION: Our study indicates that frailty is an independent predictor of mortality among patients with COVID-19. Thus, frailty could be a prognostic factor for clinicians to stratify high-risk groups and remind doctors and nurses to perform early screening and corresponding interventions urgently needed to reduce mortality rates in patients infected by SARS-CoV-2.


Assuntos
Fragilidade , Idoso , Idoso Fragilizado , Fragilidade/diagnóstico , Humanos , Prevalência
9.
Yonsei Med J ; 62(3): 249-254, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33635015

RESUMO

PURPOSE: The purpose of this study was to evaluate the prevalence of frailty among an older adult population living in rural communities and to determine if frailty is associated with nutritional status after adjusting for sarcopenia and depression. MATERIALS AND METHODS: This research used baseline data from the Namgaram-2 study. Frailty was evaluated using the Kaigo-Yobo checklist in an older Korean population. The nutritional statuses of older people were measured using the Korean version of the mini nutritional assessment (MNA). The recent criteria of the Asian Working Group for Sarcopenia were applied for diagnosis of sarcopenia, and depression was assessed using the Geriatric Depression Scale-Short Form. RESULTS: The prevalence of frailty was 18.8% (male: 9.6%; female: 23.4%) and was significantly higher in individuals in their 80s [male, 35.3% (p<0.001); female, 42.3% (p<0.001)], those of poor economic status [male, 18.2% (p=0.012); female, 34.9% (p<0.001)], those with hypertension [female, 27.7% (p=0.008)], those with sarcopenia [male, 34.1% (p<0.001); female, 37.2% (p<0.001)], those with depression [male, 46.4% (p<0.001); female, 51.7% (p<0.001)], and those at high risk of malnutrition [male, 44.4% (p<0.001); female, 51.7% (p<0.001)]. After adjusting for demographic variables, including hypertension, diabetes, sarcopenia and depression, frailty was significantly associated with nutritional status [male: odds ratio (OR)=6.73, 95% confidence interval (CI), 1.84-24.65; female: OR=4.83, 95% CI, 2.88-8.11]. CONCLUSION: For older adults, MNA is a suitable tool of use in assessing both nutritional status and frailty. Moreover, the nutritional status of older adults appears to be associated with frailty, even after corrections for physical and psychological function.


Assuntos
Grupo com Ancestrais do Continente Asiático , Desnutrição/epidemiologia , População Rural , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fragilidade/epidemiologia , Humanos , Modelos Logísticos , Masculino , Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Prevalência , Fatores de Risco , Fatores Socioeconômicos
10.
Am Fam Physician ; 103(4): 219-226, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33587574

RESUMO

Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults, is a state of increased vulnerability across multiple health domains that leads to adverse health outcomes. Frail older adults are at increased risk of falls, disability, hospitalizations, and death. Frailty may initially be overlooked or incorrectly identified as part of the normal aging process because of the variable nature of the presentation and diagnosis. Symptoms include generalized weakness, exhaustion, slow gait, poor balance, decreased physical activity, cognitive impairment, and weight loss. There is no current recommendation for routine screening. A comprehensive geriatric assessment can identify risk factors and symptoms that suggest frailty. Several validated frailty assessment tools can evaluate a patient for frailty. Patients are diagnosed as not-frail, prefrail, or frail. Patients with a larger number of frail attributes are at higher risk of poor outcomes. The management of frail patients must be individualized and tailored to each patient's goals of care and life expectancy. Physical activity and balance exercises may be suitable for patients who are less frail. Palliative care and symptom control may be appropriate for those who are more frail.


Assuntos
Pessoas com Deficiência , Terapia por Exercício/métodos , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/diagnóstico , Fragilidade/terapia , Avaliação Geriátrica/métodos , Cuidados Paliativos/métodos , Idoso , Idoso de 80 Anos ou mais , Currículo , Educação Médica Continuada , Feminino , Humanos , Masculino , Fatores de Risco , Estados Unidos
11.
Environ Health Prev Med ; 26(1): 25, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607942

RESUMO

BACKGROUND: There is little data on the association between the lower nutrition represented by serum albumin levels and related factors in a general population. The present study aimed to determine whether the albumin level positioned as some kind of biomarker with frailty measures, trace elements, and an inflammation marker. METHODS: In 2018, we performed an epidemiological survey in 1368 subjects who resided in Tanushimaru, Japan, in which we examined the blood chemistry including albumin, trace elements, hormone levels, and carotid ultrasonography. Albumin levels were categorized into 4 groups (G1 [3.2-3.9 mg/dL], G2 [4.0-4.3 mg/dL], G3 [4.4-4.6 mg/dL], and G4 [4.7-5.3 mg/dL]). The participants underwent measurements of handgrip strength and were tested by asking to walk 5 m. Their cognitive functions were evaluated by the mini-mental state examination (MMSE). RESULTS: Multiple stepwise regression analysis demonstrated that albumin levels were significantly and independently associated with age (inversely), systolic blood pressures, estimated glomerular filtration rate (eGFR), MMSE score, frailty measures (handgrip strength), an inflammation marker (high-sensitivity C-reactive protein), hormones (growth hormone (inversely) and insulin-like growth factor-1), and trace elements (calcium, magnesium, iron, and zinc), with a linear trend. CONCLUSIONS: Lower albumin levels, even in the normal range, were found to be related factors of frailty measures, trace elements, and an inflammation marker in a general population.


Assuntos
Albuminas/metabolismo , Fragilidade/fisiopatologia , Força da Mão/fisiologia , Inflamação/sangue , Oligoelementos/sangue , Idoso , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Japão , Masculino
13.
Nihon Ronen Igakkai Zasshi ; 58(1): 101-110, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33627545

RESUMO

AIM: To investigate the longitudinal association between health literacy and frailty status at two-year follow-up in community-dwelling older adults. METHODS: A total of 218 older adults (mean age, 72.5±4.9 [range 65-86] years old; men, n=81) without frailty at baseline participated in this study. Functional health literacy was assessed using the Newest Vital Sign (NVS). Comprehensive health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Comprehensive health literacy indices are constructed as a general health literacy index comprising all items along with the three sub-indices of health care, disease prevention, and health promotion domains. Demographic data and other potential confounding factors were also assessed. The total Kihon checklist score was used to monitor the presence of frailty based on a score of ≥8 at the 2-year follow-up (postal survey). RESULTS: Of the 253 participants in the follow-up survey, 226 responded (response rate: 89.3%). Excluding the 8 participants with missing values, 25 (11.5%) of the 218 were reported to be frail. A multiple logistic regression analysis indicated that comprehensive health literacy (total score of HLS-EU-Q47) was independently associated with a lower risk of frailty (odds ratio per standard deviation = 0.54, 95% confidence interval = 0.33-0.87) after adjusting for the covariates (age, gender, education, body mass index, gait speed, cognitive function, and comorbidities). The health care and disease prevention domain scores of the HLS-EU-Q47 were also independently associated with a lower risk of frailty. Functional health literacy (NVS score) was not associated with frailty. CONCLUSIONS: Older adults with higher comprehensive health literacy are less likely to be frail at two-year follow-up than those with a lower literacy.


Assuntos
Fragilidade , Letramento em Saúde , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Vida Independente , Masculino , Estudos Prospectivos
18.
J Frailty Aging ; 10(2): 176-181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33575708

RESUMO

BACKGROUND: Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which are scalable to large populations. OBJECTIVES: To validate a sensor-based frailty assessment tool in AYA CCS, compare frailty status between CCS and controls, and assess the correlation between frailty and number of CCS comorbidities. DESIGN, SETTING, AND PARTICIPANTS: Mean frailty index (MFI) was assessed by a frailty wrist sensor in 32 AYA CCS who were ≥1 year off therapy and in remission. Results were compared with 32 AYA controls without cancer or chronic disease. MEASUREMENTS: Frailty assessments with and without a simultaneous cognitive task were performed to obtain MFI. Results were compared between cases and controls using a Student t test, and the number of pre-frail/frail subjects by Chi Square test. The contribution of radiation therapy (RT) exposure to MFI was assessed in a sub-analysis, and the correlation between the number of comorbidities and MFI was measured using the Pearson method. RESULTS: MFI was strongly correlated with gait speed in AYA CCS. CCS were more likely to be pre-frail than controls without cancer history (p=0.032), and CCS treated with RT were more likely to be pre-frail than CCS not treated with RT (p<0.001). The number of comorbidities was strongly correlated with MFI (ρ=0.65), with a 0.028 increase in MFI for each added condition (p<0.001). CONCLUSIONS: Results from this study support higher risk for frailty among CCS, especially those with multiple comorbidities or who were treated with RT. A wrist-worn sensor-based method is feasible for application in AYA CCS, and provides an opportunity for cost-effective, rapid screening of at-risk AYA CCS who may benefit from early interventions.


Assuntos
Sobreviventes de Câncer , Fragilidade , Dispositivos Eletrônicos Vestíveis , Adolescente , Sobreviventes de Câncer/estatística & dados numéricos , Estudos de Casos e Controles , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Projetos Piloto , Medição de Risco/métodos , Adulto Jovem
19.
Artigo em Russo | MEDLINE | ID: mdl-33580764

RESUMO

OBJECTIVE: To test the hypothesis that weak electromagnetic fields of low frequencies (0.5-26 Hz) could affect daytime sleep features and structure. MATERIAL AND METHODS: Parameters of daytime sleep continuity were compared in the study with counterbalanced control/exposition (40 min exposure to electromagnetic field at 1 Hz/0.004 µT) scheme in 22 healthy volunteers. Nonlinear regression model was used to assess daytime sleep continuity. RESULTS: Exposure to a weak electromagnetic field of ultra-low frequency significantly improved the quality of sleep, assessed by the indicator of sleep continuity, namely, there were fewer transitions from the second and deeper stages of sleep to the first stage and to the state of wakefulness (p<0.0001). CONCLUSION: The results can be used to develop non-pharmacological methods of sleep correction, as well as to improve the quality of short-term sleep and its positive effect on well-being, cognitive function and working capacity.


Assuntos
Campos Eletromagnéticos , Fragilidade , Cognição , Humanos , Sono , Vigília
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