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      Correlation between frail status and lower extremity function in elderly inpatients with hypertension Translated title: Correlación entre estado frágil y función muscular de pacientes ancianos hospitalizados con hipertensión

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          Abstract

          Abstract Introduction: the frail status of elderly hypertensive patients easily damages the function of many physiological systems. Objectives: we aimed to investigate the correlation between the frail status and lower extremity function of elderly hospitalized patients with hypertension. Methods: a total of 336 eligible subjects were assigned to frail, pre-frail and non-frail groups according to the “Frail” scale. Lower extremity function was assessed by the Short Physical Performance Battery including chair-sit-to-stand, three-posture balance and 6-meter gait speed tests. The influences of factors on frailty were evaluated using the Cox multivariate regression analysis. The correlation between frailty score and lower extremity function score was explored by Spearman's analysis. The values of factors for predicting frail status were analyzed by plotting receiver operating characteristic (ROC) curves. Results: the three groups had similar age, systolic blood pressure, and nutritional, sleepiness and lower extremity function statuses (p < 0.05). Compared with the non-frail group, the lower extremity function score of the frail group was lower (p < 0.05). Age, systolic blood pressure and sleepiness status were the independent risk factors of frailty (p < 0.05), and lower extremity function parameters were independent protective factors (p < 0.05). There were negative correlations between frail status and lower extremity function parameters (p < 0.05). The area under the ROC curve was 0.850, and the optimal cutoff value was 7.80. Lower extremity function had a high value for predicting frail status. Conclusions: lower extremity function is negatively correlated with the frail status of elderly hospitalized patients with hypertension, as a protective factor of frailty, which can be used to predict frail status.

          Translated abstract

          Resumen Introducción: el estado frágil de los pacientes hipertensos de edad avanzada daña fácilmente la función de muchos sistemas fisiológicos. Objetivos: nuestro objetivo fue investigar la correlación entre el estado frágil y la función muscular de pacientes ancianos hospitalizados con hipertensión. Métodos: un total de 336 sujetos elegibles fueron asignados a grupos de frágiles, pre-frágiles y no frágiles de acuerdo con la escala de fragilidad. La función muscular se evaluó mediante la batería de rendimiento físico corto, que incluye las pruebas de sentarse y levantarse de una silla, equilibrio de tres posturas y velocidad de marcha de 6 metros. Las influencias de los factores sobre la fragilidad se evaluaron mediante el análisis de regresión multivariante de Cox. La correlación entre el puntaje de fragilidad y el puntaje de función muscular se exploró con el análisis de Spearman. Los valores de los factores para predecir el estado frágil se analizaron mediante el trazado de curvas características de funcionamiento del receptor (ROC). Resultados: los tres grupos tenían edades similares y valores similares de presión arterial sistólica y estado nutricional, somnolencia y función muscular (p < 0,05). En comparación con el grupo no frágil, la puntuación de la función muscular del grupo frágil fue menor (p < 0,05). La edad, la presión arterial sistólica y el estado de somnolencia fueron los factores de riesgo independientes de fragilidad (p < 0,05), y los parámetros de función muscular fueron factores protectores independientes (p < 0,05). Hubo correlaciones negativas entre el estado frágil y los parámetros de la función muscular (p < 0,05). El área bajo la curva ROC fue de 0,850 y el valor de corte óptimo fue de 7,80. La función muscular tuvo un valor alto para predecir el estado frágil. Conclusiones: la función muscular se correlaciona negativamente con el estado frágil de los pacientes ancianos hospitalizados con hipertensión, como factor protector de la fragilidad, que se puede utilizar para predecir el estado frágil.

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          Most cited references20

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          Frailty syndrome: an overview

          Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes. Two major frailty models have been described in the literature. The frailty phenotype defines frailty as a distinct clinical syndrome meeting three or more of five phenotypic criteria: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. The frailty index defines frailty as cumulative deficits identified in a comprehensive geriatric assessment. Significant progress has recently been made in understanding the pathogenesis of frailty. Chronic inflammation is likely a key pathophysiologic process that contributes to the frailty syndrome directly and indirectly through other intermediate physiologic systems, such as the musculoskeletal, endocrine, and hematologic systems. The complex multifactorial etiologies of frailty also include obesity and specific diseases. Major clinical applications include risk assessment and stratification. This can be applied to the elderly population in the community and in a variety of care settings. Frailty may also be useful for risk assessment in surgical patients and those with cardiovascular diseases, cancer, or human immunodeficiency virus infection, as well as for assessment of vaccine effectiveness in older adults. Currently, exercise and comprehensive geriatric interdisciplinary assessment and treatment are key interventions for frailty. As understanding of the biologic basis and complexity of frailty further improves, more effective and targeted interventional strategies and innovative geriatric-care models will likely be developed.
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            Delaying and reversing frailty: a systematic review of primary care interventions

            Recommendations for routine frailty screening in general practice are increasing as frailty prevalence grows. In England, frailty identification became a contractual requirement in 2017. However, there is little guidance on the most effective and practical interventions once frailty has been identified.
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              Importance of frailty in patients with cardiovascular disease.

              Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality. With the ageing population, the prognostic determinants among others include frailty, health status, disability, and cognition. These constructs are seldom measured and factored into clinical decision-making or evaluation of the prognosis of these at-risk older adults, especially as it relates to high-risk interventions. Addressing this need effectively requires increased awareness and their recognition by the treating cardiologists, their incorporation into risk prediction models when treating an elderly patient with underlying complex CVD, and timely referral for comprehensive geriatric management. Simple measures such as gait speed, the Fried score, or the Rockwood Clinical Frailty Scale can be used to assess frailty as part of routine care of elderly patients with CVD. This review examines the prevalence and outcomes associated with frailty with special emphasis in patients with CVD.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                February 2022
                : 39
                : 1
                : 39-45
                Affiliations
                [1] Chuzhou orgnameChuzhou City Vocation College orgdiv1Teaching and Research Office of Internal Medicine People's Republic of China
                [2] Chuzhou orgnameFirst People's Hospital of Chuzhou orgdiv1Department of Cardiovascular Medicine People's Republic of China
                Article
                S0212-16112022000100008 S0212-1611(22)03900100008
                10.20960/nh.03283
                30d8dda5-4154-4b5c-8ae5-430d00d1ca43

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 07 August 2020
                : 20 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 7
                Product

                SciELO Spain

                Categories
                Original Papers

                Correlación,Elderly,Hospitalized,Hypertension,Lower extremity function,Correlation,Mayor,Hospitalizado,Hipertensión,Función muscular

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