Geriatrics’ turning point

The Summer Book: perspectives on communication and connecting

Developing a Frailty Index from routinely collected data in the Emergency Department among of hospitalized patients Key summary points Aim To develop a Frailty Index from data routinely collected during the standard clinical assessment in the Emergency Department and to test its predictive capacity for adverse outcomes. Findings The Frailty Index presented in this study is significantly correlated with age and associated with the length of hospital stay and the risk of institutionalization. The same association was not found between age and the two outcomes. Message The use of the Frailty Index may support decisions from the very first contact of the individual with the hospital system, without burdening the clinical practice.

Absolute reliability of measurements of muscle strength and physical performance measures in older people with high functional capacities Key summary points Aim The aim of this study was to clarify the absolute reliability of muscle strength and physical performance measures in older people. Findings Only the five-times chair stand test was found to have a significant systematic error. The minimum detectable changes to the measurement value of grip strength, 5-m walking time, and the timed up and go test were all < 10%, whereas that of knee extension strength was 12%. Message Changes beyond the minimum detectable change are necessary to detect true changes in muscle strength and physical performance tests over time in community-dwelling older people.

The combination of short-step and wide-based gait is a gait characteristic in progressive supranuclear palsy: a retrospective, cross-sectional study Key summary points Aim To investigate the gait characteristics in patients with progressive supranuclear palsy compared with healthy older persons and patients with Parkinson’s disease. Findings Progressive supranuclear palsy shows Parkinsonian gait—slower walking speed and shorter step length. Step width and foot angle are larger (“wide-based-gait”) in progressive supranuclear palsy than older persons and Parkinson’s disease patients. Message Gait characteristics in progressive supranuclear palsy are combined with parkinsonism and cerebellar involvement.

Association between sarcopenia and diabetes: a systematic review and meta-analysis of observational studies Key summary points Aim To summarize the prevalence of diabetes in people with sarcopenia (and vice versa) through a meta-analytic approach of available observational studies. Findings In this work, we have presented the findings of the first full methodological systematic review and meta-analysis of observational studies exploring the relationship between diabetes and sarcopenia. Our findings overall emphasize the reciprocal relationship between diabetes and sarcopenia in terms of risk of occurrence, that is sarcopenia increases the risk of diabetes being present and vice versa. Message This study provides support for further research into the prognosis of people with both diabetes and sarcopenia and the value of interventional strategies in sarcopenia to minimize adverse outcomes such as premature death, hospitalization, and disability.

Ultrasonography to detect age-related changes in swallowing muscles Key summary points Aim To measure age-related changes in swallowing muscles by ultrasonography as a non-invasive method. Findings By ultrasonography, we found that old people had a smaller geniohyoid muscle area and greater geniohyoid muscle brightness than young people. Our analyses indicated that age and whole-body skeletal muscle mass were associated with mass and quality of the geniohyoid muscle. Message Ultrasonography effectively identified the association between atrophy of the swallowing muscles and aging and loss of whole-body skeletal muscle mass.

Long-term mortality in older adults with chronic pain: a nationwide population-based study in Taiwan Key summary points Aim There is no clear information regarding the long-term mortality in the older population with chronic pain (CP), and therefore, we conducted this study to clarify it. Findings Older participants with CP had an increased rate of long-term mortality compared to that among their counterparts without CP after adjusting for the underlying comorbidities and the causes of CP. Message Early detection and intervention for treating CP are suggested for this population.

Sarcopenia and diabetes mellitus: evidence for a bi-directional relationship

The impact of aging on pressure pain thresholds: are men less sensitive than women also in older age? Key summary points Message Gender differences in pain perception change in advanced age, with men presenting a steeper reduction in pain threshold than women with aging. Aim To evaluate whether the gender differences in pain perception change with aging. Findings Female gender and older age were associated with lower pressure pain thresholds, but difference between genders reduced from young to middle to old adult.