bims-aucach 2022-04-03 papers

bims-aucach

Biomed News

on Autophagy and cachexia

Issue of 2022–04–03
fiveteen papers selected by
Kleiton Silva, Rowan University

Role of exercise in estrogen deficiency-induced sarcopenia.
Regulatory networks controlling mitochondrial quality control in skeletal muscle.
(Dys)regulation of Protein Metabolism in Skeletal Muscle of Humans With Obesity.
Human skeletal muscle size with ultrasound imaging: a comprehensive review.
Nutritional status and quality of life are associated with risk of sarcopenia in nursing home residents: a cross-sectional study.
Aerobic exercise is an independent determinant of levels of inflammation and oxidative stress in middle-aged obese females.
Creative dance associated with traditional Portuguese singing as a strategy for active aging: a comparative cross-sectional study.
Resistance training protects against muscle pain through activation of androgen receptors in male and female mice.
Muscle-strengthening activities to improve health outcomes: what the evidence supports.
Decreased cognitive function is associated with impaired spatiotemporal gait performance in community dwelling older adults with chronic musculoskeletal pain.
Normative data for three physical frailty parameters in an aging, rural Indian population.
A review of autophagy mechanism of statins in the potential therapy of Alzheimer's disease.
Gender differences in risk factors for the 2 year development of sarcopenia in community-dwelling older adults.
Older adults with a higher frailty index tend to have electrolyte imbalances.
Measures of Frailty in Homebound Older Adults.

J Exerc Rehabil. 2022 Feb;18(1): 2-9

Role of exercise in estrogen deficiency-induced sarcopenia.

Eun-Jeong Cho, Youngju Choi, Su-Jeen Jung, Hyo-Bum Kwak.

  A decline in estrogen levels during menopause is associated with the loss of muscle mass and function, and it can accelerate sarcopenia. However, with the growing number of postmenopausal women due to the increase in life expectancy, the effects of estrogen on skeletal muscle are not completely understood. This article reviews the relationship between estrogen deficiency and skeletal muscle, its potential mechanisms, including those involving mitochondria, and the effects of exercise on estrogen deficiency-induced skeletal muscle impairment. In particular, mitochondrial dysfunction induced by estrogen deficiency accelerates sarcopenia via mitochondrial dynamics, mitophagy, and mitochondrial-mediated apoptosis. It is well known that exercise training is essential for health, including for the improvement of sarcopenia. This review highlights the importance of exercise training (aerobic and resistance exercise) as a therapeutic intervention against estrogen deficiency-induced sarcopenia.

Keywords:  Estrogen; Exercise training; Sarcopenia; Skeletal muscle

DOI:  https://doi.org/10.12965/jer.2244004.002
Am J Physiol Cell Physiol. 2022 Mar 30.

Regulatory networks controlling mitochondrial quality control in skeletal muscle.

Mikhaela B Slavin, Jonathan M Memme, Ashley N Oliveira, Neushaw Moradi, David A Hood.

The adaptive plasticity of mitochondria within skeletal muscle is regulated by signals converging on a myriad of regulatory networks that operate during conditions of increased (i.e. exercise) and decreased (inactivity, disuse) energy requirements. Notably, some of the initial signals that induce adaptive responses are common to both conditions, differing in their magnitude and temporal pattern, to produce vastly opposing mitochondrial phenotypes. In response to exercise, signaling to PGC-1α and other regulators ultimately produces an abundance of high quality mitochondria, leading to reduced mitophagy and a higher mitochondrial content. This is accompanied by the presence of an enhanced protein quality control system that consists of the protein import machinery as well chaperones and proteases termed the UPRmt. The UPRmt monitors intra-organelle proteostasis, and strives to maintain a mito-nuclear balance between nuclear- and mtDNA-derived gene products via retrograde signaling from the organelle to the nucleus. In addition, antioxidant capacity is improved, affording greater protection against oxidative stress. In contrast, chronic disuse conditions produce similar signaling but result in decrements in mitochondrial quality and content. Thus, the interactive cross-talk of the regulatory networks that control organelle turnover during wide variations in muscle use and disuse remain incompletely understood, despite our improving knowledge of the traditional regulators of organelle content and function. This brief review acknowledges existing regulatory networks and summarizes recent discoveries of novel biological pathways involved in determining organelle biogenesis, dynamics, mitophagy, protein quality control and antioxidant capacity, identifying ample protein targets for therapeutic intervention that determine muscle and mitochondrial health.

DOI: https://doi.org/10.1152/ajpcell.00065.2022
Front Physiol. 2022 ;13 843087

(Dys)regulation of Protein Metabolism in Skeletal Muscle of Humans With Obesity.

Eduardo D S Freitas, Christos S Katsanos.

  Studies investigating the proteome of skeletal muscle present clear evidence that protein metabolism is altered in muscle of humans with obesity. Moreover, muscle quality (i.e., strength per unit of muscle mass) appears lower in humans with obesity. However, relevant evidence to date describing the protein turnover, a process that determines content and quality of protein, in muscle of humans with obesity is quite inconsistent. This is due, at least in part, to heterogeneity in protein turnover in skeletal muscle of humans with obesity. Although not always evident at the mixed-muscle protein level, the rate of synthesis is generally lower in myofibrillar and mitochondrial proteins in muscle of humans with obesity. Moreover, alterations in the synthesis of protein in muscle of humans with obesity are manifested more readily under conditions that stimulate protein synthesis in muscle, including the fed state, increased plasma amino acid availability to muscle, and exercise. Current evidence supports various biological mechanisms explaining impairments in protein synthesis in muscle of humans with obesity, but this evidence is rather limited and needs to be reproduced under more defined experimental conditions. Expanding our current knowledge with direct measurements of protein breakdown in muscle, and more importantly of protein turnover on a protein by protein basis, will enhance our understanding of how obesity modifies the proteome (content and quality) in muscle of humans with obesity.

Keywords:  metabolic disease; muscle; myopathology; obesity; proteome

DOI:  https://doi.org/10.3389/fphys.2022.843087
J Appl Physiol (1985). 2022 Mar 31.

Human skeletal muscle size with ultrasound imaging: a comprehensive review.

Masatoshi Naruse, Scott W Trappe, Todd A Trappe.

  Skeletal muscle size is an important factor in assessing adaptation to exercise training and detraining, athletic performance, age-associated atrophy and mobility decline, clinical conditions associated with cachexia, and overall skeletal muscle health. Magnetic resonance (MR) imaging and computed tomography (CT) are widely accepted as the gold standard methods for skeletal muscle size quantification. However, it is not always feasible to use these methods (e.g., field studies, bedside studies, large cohort studies). Ultrasound has been available for skeletal muscle examination for more than 50 years and the development, utility, and validity of ultrasound imaging are underappreciated. It is now possible to use ultrasound in situations where MR and CT imaging are not suitable. This review provides a comprehensive summary of ultrasound imaging and human skeletal muscle size assessment. Since the first study in 1968, more than 600 articles have used ultrasound to examine the cross-sectional area and/or volume of 107 different skeletal muscles in more than 27,500 subjects of various ages, health status, and fitness conditions. Data from these studies, supported by decades of technological developments, collectively show that ultrasonography is a valid tool for skeletal muscle size quantification. Considering the wide-ranging connections between human health and function and skeletal muscle mass, the utility of ultrasound imaging will allow it to be employed in research investigations and clinical practice in ways not previously appreciated or considered.

Keywords:  Skeletal muscle mass; ultrasound; whole muscle imaging

DOI:  https://doi.org/10.1152/japplphysiol.00041.2022
Nutr Res. 2022 Feb 18. pii: S0271-5317(22)00007-0. [Epub ahead of print]101 14-22

Nutritional status and quality of life are associated with risk of sarcopenia in nursing home residents: a cross-sectional study.

Hilal Şimşek, Aslı Uçar.

  Sarcopenia, which is characterized by an age-related decline in skeletal muscle mass, strength, and function, is an important geriatric syndrome that is closely related to the nutritional status and quality of life (QoL) of older adults. The aim of this study was to compare the nutritional status and QoL of nursing home residents according to sarcopenia. We hypothesized that a daily protein intake <1.2 g/kg is associated with a higher risk of sarcopenia. This study was performed with 172 older adults living a nursing home. Sarcopenia was defined according to the consensus of the European Working Group on Sarcopenia in Older People. The nutritional status was evaluated using the Mini Nutritional Assessment-Short Form, 24-hour dietary recall. Frailty was evaluated using the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale and health-related QoL was evaluated by the European Quality of Life-5 Dimensions scale. In addition to the anthropometric measurements associated with sarcopenia, QoL was also lower in sarcopenic individuals. The risk of malnutrition and frailty status were more prevalent among the sarcopenic individuals. In the multivariate logistic regression analysis, a higher QoL score was related with a low risk for sarcopenia, whereas the risk of malnutrition, a daily protein intake that was <1.2 g/kg/d, and being >80 years of age remained predictive of sarcopenia after adjustment. Sarcopenic nursing home residents have a great risk of malnutrition and lower QoL. This study showed that QoL, the risk of malnutrition, and daily protein intake are important factors as potential target areas for the management of sarcopenia in nursing home residents.

Keywords:  Frailty; Nursing home; Nutrition; Older adults; Quality of life; Sarcopenia

DOI:  https://doi.org/10.1016/j.nutres.2022.02.002
J Exerc Rehabil. 2022 Feb;18(1): 43-49

Aerobic exercise is an independent determinant of levels of inflammation and oxidative stress in middle-aged obese females.

Kyung-Shin Park, Brett S Nickerson.

  The purpose of this study was to investigate the effects of a 4-week moderate-intensity aerobic exercise on changes of body composition and markers of inflammation and oxidative stress independent from weight loss in middle-aged obese females. Thity-five obese females were randomly assigned to either an exercise (EX, N=16) or control (CON, N=19) group. The EX performed moderate intensity aerobic exercise on the treadmill for 60 min at 55% of maximal oxygen consumption (VO2max) for 4 weeks (3 days/wk). Body composition measurement with dual-energy x-ray absorptiometry and blood collection were conducted before and after the 4-weeks intervention. Blood samples were used to measure levels of tumor necrosis factor-alpha (TNF-α), C-reactive protein, adiponectin, total antioxidant status (TAS), and 8-hydroxydeoxyguanosine. Four weeks of aerobic exercise intervention significantly increased VO2max in EX (P<0.001). EX also observed a decrease in TNF-α (P=0.033) and an increase in TAS (P=0.028) without changes in body weight and fat mass after 4 weeks of aerobic exercise training. No changes were observed in CON after the intervention. Results of this study indicate that moderate aerobic exercises may contribute, at least a part, to reductions of inflammation and oxidative stress independently from fat loss. Therefore, it may reduce risks of obesity-associated disorders in middle-aged obese females.

Keywords:  Aerobic exercise; Body composition; Inflammatory cytokines; Obesity; Oxidative stress

DOI:  https://doi.org/10.12965/jer.2142724.352
BMC Public Health. 2022 Mar 29. 21(Suppl 2): 2334

Creative dance associated with traditional Portuguese singing as a strategy for active aging: a comparative cross-sectional study.

Paulo Coelho, José Marmeleira, Ana Cruz-Ferreira, Luís Laranjo, Catarina Pereira, Jorge Bravo.

   BACKGROUND: Multimodal forms of exercise can influence several physical and mental factors important for successful aging. In the present study, we introduce a new type of multimodal intervention, combining movement (creative dance) with traditional singing. This study aims to compare physical fitness, functional physical independence, depressive symptoms, general cognitive status, and daytime sleepiness among older adults participating in multimodal exercise, those participating in traditional physical exercise, and those not actively engaged in physical exercise.
METHODS: This cross-sectional study included 112 people aged ≥ 65 years (75.3 ± 0.7 years) living independently in the community, divided into 3 groups: multimodal exercise (n = 34), traditional exercise (n = 41), and no physical exercise (n = 37).
RESULTS: The multimodal exercise group showed greater flexibility of the lower limbs and upper limbs/shoulders and better general cognitive status than the traditional exercise group (p < 0.05). The traditional exercise group had better agility and dynamic balance, aerobic endurance, and strength of the lower and upper limbs than the no-exercise group (p < 0.05).
CONCLUSIONS: The results suggest that the two types of programs studied may have different impacts on some of the variables investigated and support the design of future experimental studies that include interventions based on the combination of creative dance and traditional Portuguese singing.

Keywords:  Expressive movement; Older adults; Physical fitness; Singing; “Cante Alentejano”

DOI:  https://doi.org/10.1186/s12889-022-12978-4
Pain. 2022 Mar 24.

Resistance training protects against muscle pain through activation of androgen receptors in male and female mice.

Joseph B Lesnak, Alexis Fahrion, Amber Helton, Lynn Rasmussen, Megan Andrew, Stefanie Cunard, Michaela Huey, Austin Kreber, Joseph Landon, Travis Siwiec, Kenan Todd, Laura A Frey-Law, Kathleen A Sluka.

ABSTRACT: Resistance training-based exercise is commonly prescribed in the clinic for the treatment of chronic pain. Mechanisms of aerobic exercise for analgesia are frequently studied, while little is known regarding resistance training mechanisms. We developed a resistance training model in mice and hypothesized resistance training would protect against development of muscle pain, mediated through the activation of androgen receptors. Activity induced muscle hyperalgesia was produced by two injections of pH 5.0 stimuli with fatiguing muscle contractions. Resistance training was performed by having mice climb a ladder with attached weights, 3x per week. Resistance training acutely increased blood lactate and prolonged training increased strength measured via forepaw grip strength and 1 repetition maximum, validating the exercise program as a resistance training model. Eight weeks of resistance training prior to induction of the pain model blocked the development of muscle hyperalgesia in both sexes. Resistance training initiated after induction of the pain model reversed muscle hyperalgesia in males only. A single resistance training bout acutely increased testosterone in male but not female mice. Administration of the androgen receptor antagonist flutamide (200mg pellets) throughout the eight-week training program blocked the exercise induced protection against muscle pain in both sexes. However, single administration of flutamide (1, 3, 10mg/kg) in resistance trained animals had no effect on existing exercise induced protection against muscle pain. Therefore, resistance training acutely increases lactate and testosterone and strength overtime. Eight weeks of resistance training prevents development of hyperalgesia through activation of androgen receptors in an animal model of muscle pain.

DOI: https://doi.org/10.1097/j.pain.0000000000002638
Br J Sports Med. 2022 Mar 31. pii: bjsports-2022-105481. [Epub ahead of print]

Muscle-strengthening activities to improve health outcomes: what the evidence supports.

Katherine Rose Marino, Dane Vishnubala, Pekka Oja.



Keywords:  Exercise; Muscle; Physical activity

DOI:  https://doi.org/10.1136/bjsports-2022-105481
Brain Cogn. 2022 Mar 28. pii: S0278-2626(22)00020-3. [Epub ahead of print]159 105862

Decreased cognitive function is associated with impaired spatiotemporal gait performance in community dwelling older adults with chronic musculoskeletal pain.

Ania L Lipat, Jessica A Peterson, David J Clark, Yenisel Cruz-Almeida.

   OBJECTIVE: Older adults with chronic musculoskeletal pain often suffer from cognitive impairments and diminished lower extremity physical function. Prior work suggests that these impairments may be interrelated, however, the relationship between cognition and spatiotemporal gait performance in this population is understudied. Therefore, the purpose of this study was to examine the association between cognition and spatiotemporal gait performance and determine if cognition mediates the relationship between pain severity and spatiotemporal gait performance in older adults with chronic musculoskeletal pain without cognitive impairment.
METHODS: Older adults with chronic musculoskeletal pain (n = 36) completed the Montreal Cognitive Assessment (MoCA) to assess global cognitive function. Spatiotemporal gait analysis was completed using an automated gait mat. Hierarchical regressions and mediation analyses were used to assess the relationship between chronic musculoskeletal pain, cognition, and spatiotemporal gait performance.
RESULTS: MoCA scores were significantly associated with double support time, with lower MoCA scores relating with longer double support times (β = -0.686, p = 0.039). After accounting for cognition, pain severity was also associated with slower gait speed (β = -0.422, p = 0.019), and double support time (β = 0.454, p = 0.008). Cognition, however, did not mediate the relationship between pain severity and double support time.
CONCLUSIONS: Global cognition and pain severity were associated with spatiotemporal gait performance in older adults with chronic pain. Pain severity, but not cognition, however, primarily explained spatiotemporal gait performance in our sample. Future work is needed to elucidate the role of cognition in spatiotemporal gait performance in older adults with chronic musculoskeletal pain.

Keywords:  Chronic pain; Cognition; Spatiotemporal gait performance; Support time

DOI:  https://doi.org/10.1016/j.bandc.2022.105862
Health Sci Rep. 2022 Mar;5(2): e567

Normative data for three physical frailty parameters in an aging, rural Indian population.

Jonas S Sundarakumar, Karru V Raviteja, Graciela Muniz-Terrera, Vijayalakshmi Ravindranath.

   Introduction: Physical frailty is associated with multiple adverse health outcomes. Since physical characteristics markedly vary with different populations, population-specific norms for physical frailty parameters are necessary. Such norms are lacking for the Indian population, especially for older, rural Indians. We aimed to develop normative values for three quantitative, frailty parameters-handgrip strength, "Timed Up-and-Go" (TUG) test time, and physical activity in an aging, rural Indian population.
Methods: The study sample is from an ongoing, prospective, cohort (Srinivaspura NeuoSenescence and COGnition, SANSCOG) comprised of rural, community-dwelling, cognitively healthy, aging Indians. Subjects are recruited through area sampling strategy, from villages of Srinivaspura, Kolar district, Karnataka state, India. Three physical frailty parameters of Fried's phenotype-handgrip strength (n = 1787), TUG time (n = 1863), and physical activity (n = 1640) were assessed using digital hand dynamometry, TUG test, and General Physical Activity Questionnaire (GPAQ), respectively.
Results: The 10th, 25th, 50th, 75th, 90th percentiles for the three frailty parameters were: right-hand grip strength (kg): males-13.9, 18.6, 23.8, 28.7, 33.7 and females-7.8, 10.6, 14.2, 17.9, 21.3; left-hand grip strength (kg): males-13.3, 18.3, 23.6, 28.9, 32.9 and females-7.9, 10.5, 14.3, 17.8, 21.2; TUG time (s): males-9.1, 10.1, 11.4, 13.4, 15.5 and females-9.5, 10.7, 12.4, 14.5, 16.6; physical activity (MET-minutes/week): males-1680; 4320; 8880; 15,840; 23,352 and females-1680; 4320; 9240; 15,120; 20,160.
Discussion: Our findings show that from 45 years onwards, overall grip strength decreases and TUG time increases, with women performing significantly poorer than men across all age groups, except >75 years, where no differences were seen. Physical activity did not show any consistent trend according to age or gender. Reference values for this aging, rural Indian population were substantially lower for grip strength and higher for TUG time than aging populations in several Western and other Asian countries.

Keywords:  Timed Up‐and‐Go (TUG); frailty; functional mobility; handgrip strength; physical activity

DOI:  https://doi.org/10.1002/hsr2.567
J Integr Neurosci. 2022 Mar 18. 21(2): 46

A review of autophagy mechanism of statins in the potential therapy of Alzheimer's disease.

Lu Liu, Wen-Zhuo Dai, Xi-Chen Zhu, Tao Ma.

  Alzheimer's disease (AD) is a neurodegeneration csharacterized by amyloid-β (Aβ) deposition and abnormally phosphorylated Tau protein aggregation. Autophagy, as an important cellular metabolic activity, is closely related to the production, secretion and clearance of Aβ peptide and Tau phosphorylation level. Therefore, autophagy may become a potential target for AD treatment. A large number of molecules are involved in the mammalian target of rapamycin (mTOR)-dependent or mTOR-independent pathway of autophagy. More and more evidences show that statins can intervene autophagy by regulating the activity or expression level of autophagy-related proteins and genes. On the one hand, statins can induce autophagy through Sirtuin1 (SIRT1), P21, nuclear P53 and adenylate activated protein kinase (AMPK). On the other hand, statins inhibit the mevalonate metabolism pathway, thereby interfering with the prenylation of small GTPases, leading to autophagy dysfunction. Statins can also reduce the levels of LAMP2 and dynein, destroying autophagy. In this review, we focused on the role of autophagy in AD and the autophagy mechanism of statins in the potential treatment of AD.

Keywords:  Alzheimer's disease; Amyloid-β; Autophagy; Autophagy flux; Mevalonate pathway; Statin; Tau protein

DOI:  https://doi.org/10.31083/j.jin2102046
J Cachexia Sarcopenia Muscle. 2022 Apr 01.

Gender differences in risk factors for the 2 year development of sarcopenia in community-dwelling older adults.

Hun Jee Choe, Be Long Cho, Yong Soon Park, Eun Roh, Hyeon Ju Kim, Sam-Gyu Lee, Bong Jo Kim, Miji Kim, Chang Won Won, Kyong Soo Park, Hak Chul Jang.

   BACKGROUND: Sarcopenia is an age-related chronic condition that can lead to mobility disabilities. This study aimed to evaluate the risk factors for incident sarcopenia in older Korean adults.
METHODS: The Korean Frailty and Aging Cohort Study (KFACS) is a multicentre prospective study with a baseline examination in 2016-2017. A prospective follow-up study was conducted in 2018-2019. Changes in muscle-related variables were evaluated for subjects aged 70-84 years lacking sarcopenia at baseline. Sarcopenia was diagnosed according to the 2019 updated Asian Working Group for Sarcopenia consensus.
RESULTS: Among the 1636 participants (54.4% women, age 75.9 ± 3.7) who did not have sarcopenia at baseline, 101 men (13.5%) and 104 women (11.7%) developed sarcopenia by the follow-up. Those who developed sarcopenia were older (men, 77.9 ± 3.9 vs. 75.7 ± 3.5, P < 0.001; women, 77.5 ± 4.0 vs. 75.5 ± 3.6, P < 0.001) with a lower body mass index at baseline (men, 23.9 ± 2.4 vs. 24.5 ± 2.9 kg/m2 , P = 0.025; women, 23.7 ± 2.8 vs. 25.2 ± 2.9 kg/m2 , P < 0.001) compared with older adults who remained nonsarcopenic; levels of glycated haemoglobin (men, 6.2 ± 1.0% vs. 5.9 ± 0.8%, P = 0.029) and the homeostasis model assessment of insulin resistance (men, 2.0 ± 1.3 vs. 1.7 ± 1.2, P = 0.022) were higher in men who progressed to sarcopenia but not in women. Development of sarcopenia was associated with older age and the frequency of resistance training (≥2 per week) after adjusting for potential risk factors in men [age, odds ratio (OR) 1.17, 95% confidence interval (CI) 1.10-1.25; frequent resistance training, OR 0.50, 95% CI 0.30-0.82]. In women, advanced age, poor nutritional status, and physical inactivity contributed to the development of sarcopenia (age, OR 1.14, 95% CI 1.08-1.21; mini nutritional assessment short form, OR 0.79, 95% CI 0.70-0.90; moderate to high physical activity, OR 0.57, 95% CI 0.34-0.95).
CONCLUSIONS: In this 2 year KFACS follow-up, modifiable risk factors for incident sarcopenia differed between genders. Resistance training (≥2 per week) helped to prevent sarcopenia in these community-dwelling older men. In older women, adequate nutritional support and being physically active might play a role in preventing progression to sarcopenia.

Keywords:  Exercise; Insulin resistance; Malnutrition; Resistance training; Sarcopenia

DOI:  https://doi.org/10.1002/jcsm.12993
Exp Gerontol. 2022 Mar 25. pii: S0531-5565(22)00086-9. [Epub ahead of print] 111778

Older adults with a higher frailty index tend to have electrolyte imbalances.

Chisato Fujisawa, Hiroyuki Umegaki, Taiki Sugimoto, Chi Hsien Huang, Haruki Fujisawa, Yoshihisa Sugimura, Masafumi Kuzuya, Kenji Toba, Takashi Sakurai.

   OBJECTIVES: Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor. We hypothesized that frail older adults would tend to have electrolyte imbalances because they should have many stressors together with fragile physiological systems. In this study, we aimed to determine whether older adults with higher Frailty Index scores have electrolyte imbalances and to establish which domains of the Frailty Index are correlated with electrolyte imbalances.
DESIGN: A cross-sectional study.
SETTING AND PARTICIPANTS: A total of 4204 older adults aged 70 years or over who visited the Japanese National Center for Geriatrics and Gerontology.
METHODS: We calculated the 50-item Frailty Index with the following domains: comorbidities, cognitive function and mood, basic and instrumental activities of daily living, physical function, nutrition, and fall risks from physical weakness and comorbidities. Participants were categorized into four groups: a non-frail group (Frailty Index ≤0.2), mildly frail group (0.20 < Frailty Index ≤0.3), moderately frail group (0.3 < Frailty Index ≤0.4), and severely frail group (0.4 < Frailty Index). Their serum sodium, potassium, calcium, and phosphorus concentrations were measured. A multiple regression model was used to explore the relationship of electrolyte imbalances with the Frailty Index and to determine which frailty domains are correlated with electrolyte imbalances.
RESULTS: Compared with the non-frail group, the mildly and moderately frail groups tended to have hypernatremia and hypophosphatemia, whereas the severely frail group tended to have dysnatremia, hypokalemia, and hypophosphatemia. The estimated odds ratios increased by 15%-52% for each electrolyte imbalance as the Frailty Index increased by 0.1. The Frailty Index domains of cognitive function, activities of daily living, and nutrition were correlated with more than three kinds of electrolyte imbalances, the domains of physical function and fall risks from physical weakness were correlated with three kinds of electrolyte imbalances, and the domains of comorbidities and fall risks from comorbidities were correlated with two kinds of electrolyte imbalances.
CONCLUSIONS: Older adults with higher Frailty Index scores tend to have electrolyte imbalances.

Keywords:  Dyscalcemia; Dyskalemia; Dysnatremia; Dysphosphatemia; Electrolyte imbalance; Frailty index

DOI:  https://doi.org/10.1016/j.exger.2022.111778
South Med J. 2022 Apr;115(4): 276-279

Measures of Frailty in Homebound Older Adults.

Sara Shirai, Min Ji Kwak, Jessica Lee.

OBJECTIVES: Frailty, a geriatric syndrome associated with high morbidity and mortality, has rarely been assessed in homebound older adults. As such, we evaluated the prevalence of frailty among older adults enrolled in a home-based primary care program.
METHODS: We measured frailty using the Fried Frailty Phenotype criteria of unintentional weight loss, weakness, poor endurance, slowness, and low physical activity.
RESULTS: Of 25 homebound patients (average age 73), 14 (56%) were frail, 11 (44%) were prefrail, and none (0%) were robust. Among those who took ≥5 medications, 63% were frail and 37% were prefrail, and among those who had ≥10 comorbidities, 57% were frail and 43% were prefrail. We also observed that frailty in our homebound older adults was mainly driven by slow gait speed.
CONCLUSIONS: Frailty is prevalent in homebound older adults and may be related to slower gait speed, polypharmacy, and/or multimorbidity.

DOI: https://doi.org/10.14423/SMJ.0000000000001380