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      Dysphagia Prevalence, Time Course, and Association with Probable Sarcopenia, Inactivity, Malnutrition, and Disease Status in Older Patients Admitted to an Emergency Department: A Secondary Analysis of Cohort Study Data

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          Abstract

          There is evolving evidence for an association between dysphagia and sarcopenia in older adults. For optimizing the acute health care initiative across health care settings, this study investigated prevalence and time-course of dysphagia in older patients admitted to an emergency department (ED) as well as its association with parameters for probable sarcopenia, inactivity, malnutrition, disease status, and systemic inflammation. A secondary analysis of data from the FAM-CPH cohort study on acutely admitted older medical patients ( n = 125). Data were collected upon ED admission as well as four and 56 weeks after discharge. Using the Eating Assessment Tool cut-off score ≥ 2, signs of dysphagia were present in 34% of the patients at ED admission and persisted in 25% of the patients 56 weeks after discharge. Signs of dysphagia at 56-week follow-up were significantly ( p < 0.05) associated with probable sarcopenia (low handgrip strength (OR = 3.79), low leg muscle strength (OR = 8.14), and low physical performance (OR = 5.68)) and with baseline swallowing inactivity (OR = 5.61), malnutrition (OR = 4.35), and systemic inflammation (OR = 1.33). Signs of dysphagia in older patients admitted to an ED was prevalent, persisted 56 weeks after discharge, and was associated with probable sarcopenia and related conditions; all modifiable targets for management of dysphagia in older patients.

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          The REDCap consortium: Building an international community of software platform partners

          The Research Electronic Data Capture (REDCap) data management platform was developed in 2004 to address an institutional need at Vanderbilt University, then shared with a limited number of adopting sites beginning in 2006. Given bi-directional benefit in early sharing experiments, we created a broader consortium sharing and support model for any academic, non-profit, or government partner wishing to adopt the software. Our sharing framework and consortium-based support model have evolved over time along with the size of the consortium (currently more than 3200 REDCap partners across 128 countries). While the "REDCap Consortium" model represents only one example of how to build and disseminate a software platform, lessons learned from our approach may assist other research institutions seeking to build and disseminate innovative technologies.
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            Sarcopenia: revised European consensus on definition and diagnosis

            Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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              A 30-s chair-stand test as a measure of lower body strength in community-residing older adults.

              Measuring lower body strength is critical in evaluating the functional performance of older adults. The purpose of this study was to assess the test-retest reliability and the criterion-related and construct validity of a 30-s chair stand as a measure of lower body strength in adults over the age of 60 years. Seventy-six community-dwelling older adults (M age = 70.5 years) volunteered to participate in the study, which involved performing two 30-s chair-stand tests and two maximum leg-press tests, each conducted on separate days 2-5 days apart. Test-retest intraclass correlations of .84 for men and .92 for women, utilizing one-way analysis of variance procedures appropriate for a single trial, together with a nonsignificant change in scores from Day 1 testing to Day 2, indicate that the 30-s chair stand has good stability reliability. A moderately high correlation between chair-stand performance and maximum weight-adjusted leg-press performance for both men and women (r = .78 and .71, respectively) supports the criterion-related validity of the chair stand as a measure of lower body strength. Construct (or discriminant) validity of the chair stand was demonstrated by the test's ability to detect differences between various age and physical activity level groups. As expected, chair-stand performance decreased significantly across age groups in decades--from the 60s to the 70s to the 80s (p < .01) and was significantly lower for low-active participants than for high-active participants (p < .0001). It was concluded that the 30-s chair stand provides a reasonably reliable and valid indicator of lower body strength in generally active, community-dwelling older adults.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Geriatrics (Basel)
                Geriatrics (Basel)
                geriatrics
                Geriatrics
                MDPI
                2308-3417
                26 April 2021
                June 2021
                : 6
                : 2
                : 46
                Affiliations
                [1 ]Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark
                [2 ]Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark; rikke.lundsgaard.nielsen@ 123456regionh.dk (R.L.N.); morten.baltzer.houlind@ 123456regionh.dk (M.B.H.); juliette.tavenier@ 123456regionh.dk (J.T.); line.jee.hartmann.rasmussen@ 123456regionh.dk (L.J.H.R.); lillian.moerch.joergensen@ 123456regionh.dk (L.M.J.); ctreldal@ 123456gmail.com (C.T.); mette.merete.pedersen@ 123456regionh.dk (M.M.P.); ove.andersen@ 123456regionh.dk (O.A.); janne.petersen.01@ 123456regionh.dk (J.P.); aino.leegaard.andersen@ 123456regionh.dk (A.L.A.)
                [3 ]Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
                [4 ]The Capital Region Pharmacy, Marielundsvej 25, 2730 Herlev, Denmark
                [5 ]Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark
                [6 ]Department of Psychology and Neuroscience, Duke University, 2020 W Main St, Durham, NC 27705, USA
                [7 ]Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Kettegaards alle 30, 2650 Hvidovre, Denmark
                [8 ]Department of Nursing and Nutrition, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark; Anne.Marie.Beck@ 123456regionh.dk
                [9 ]Dietetic and Nutritional Research Unit, Herlev-Gentofte University Hospital, Borgmester Ib Juuls Vej 50, 2730 Herlev, Denmark
                [10 ]Center of Clinical Research and Prevention and Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
                [11 ]Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
                Author notes
                [* ]Correspondence: tina.hansen.18@ 123456regionh.dk ; Tel.: +45-29243586
                Author information
                https://orcid.org/0000-0002-9068-5968
                https://orcid.org/0000-0003-2208-7349
                https://orcid.org/0000-0003-4058-3012
                https://orcid.org/0000-0001-6613-2469
                https://orcid.org/0000-0001-5719-2531
                https://orcid.org/0000-0001-7323-2548
                https://orcid.org/0000-0003-1449-1931
                Article
                geriatrics-06-00046
                10.3390/geriatrics6020046
                8167602
                33926079
                edd00d24-057a-44d9-aae7-92fc50a2ea45
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 07 April 2021
                : 23 April 2021
                Categories
                Article

                swallowing difficulties,sarcopenia,inactivity,malnutrition,acute care,geriatric patients

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