Developing Topics.

Background: Cognitive frailty (CF) has been proposed as a state of reduced cognitive reserve that is intermediate between age-related cognitive changes and neurodegenerative diseases. We aim to examine (i) whether cognitive frailty presents with risk factors distinct from isolated phenotypes of physical frailty and cognitive impairment, (ii) reversibility of cognitive frailty subtypes.

Methods: Participants were older adults aged >60 years from a community frailty screening programme.

Optimising dementia screening in community-dwelling older adults: A rapid review of brief diagnostic tools in Singapore.

Introduction: Timely detection of dementia enables early access to dementia-specific care services and interventions. Various stakeholders brought together to refine Singapore's dementia care strategy identified a lack of a standardised cognitive screening tool and the absence of a comparative review of existing tools. We hence conducted a rapid review to evaluate the diagnostic performance of brief cognitive screening tools in identifying possible dementia among community-dwelling older adults in Singapore.

Single and Dual Task Gait Speed in Frailty Screening of Community-Dwelling Older Adults.

Objective: This study compares dual task (DT) gait speed between robust and frail older adults in the setting of a community-based frailty screening program.

Methods: A cross-sectional study was conducted involving older adults aged 50 years or older. Participants were categorized as robust, pre-frail or frail using the FRAIL phenotype.

Associations of 2 Established Methods of Measuring Gait Speed and Sit-To-Stand Performance with Frailty and Life-Space Mobility in Community-Dwelling Older Adults.

Objectives: The 4-m gait speed (4mGS) and 10-m gait speed (10mGS) tests and the 30-second sit-to-stand (30sSTS) and 5-times sit-to-stand (5xSTS) tests are commonly used and advocated in consensus recommendations. We compared these tests on their predictive and clinical value concerning the risk of prefrailty/frailty and restricted life-space mobility (RLSM).

Design: Cross-sectional study.

Olfactory Impairment and Frailty: A Systematic Review and Meta-Analysis.

Importance: Olfactory impairment (OI) and frailty are prevalent conditions associated with aging, but studies investigating their association with each other have been discordant.

Objective: To summarize current evidence surrounding the association between OI and frailty.

Data Sources: PubMed, Embase, Cochrane Library, SCOPUS, and CINAHL from inception to November 28, 2023.

The prevalence patterns and risk factor profiles of poor muscle health and its associated components in multiethnic older Asians: The PIONEER study.

Background: We aim to determine the multiethnic patterns of the prevalence and associated factors of poor muscle health and its associated components in older Chinese, Malays, and Indian Asian adults.

Methods: We included 2199 participants (mean age ± SD: 72.9 ± 8.

Intrinsic capacity assessment using World Health Organization Integrated Care for Older People Step 1, and the association with frailty in community dwelling older adults.

Aim: This study aimed to investigate the association between intrinsic capacity (IC) and frailty in community-dwelling older adults. Specifically, we examined the utility of the World Health Organization's Integrated Care for Older People Step 1 screen for identifying frail older persons in the community.

Methods: This is a cross-sectional analysis of a community frailty screening initiative.

Individual and combined associations of sarcopenia, osteoporosis and obesity with frailty in a multi-ethnic asian older adult population.

Background: We explored the relationships between sarcopenia (SP), osteoporosis (OP), obesity (OB), (alone and in combination) with physical frailty (PF) in a multi-ethnic, population-based study of Asians aged ≥ 60 years.

Methods: Participants were enrolled from the PopulatION HEalth and Eye Disease PRofile in Elderly Singaporeans Study (PIONEER) study. PF was defined using the modified Fried phenotype; SP using the Asian Working Group for Sarcopenia 2019; OP using bone mineral density scores; and OB using the fat mass index.

Using item response theory to estimate interpretation threshold values for the Frailty Index in community dwelling older adults.

Background: Although the frailty index (FI) is designed as a continuous measure of frailty, thresholds are often needed to guide its interpretation. This study aimed to introduce and demonstrate the utility of an item response theory (IRT) method in estimating FI interpretation thresholds in community-dwelling adults and to compare them with cutoffs estimated using the receiver operating characteristics (ROC) method.

Methods: A sample of 1,149 community-dwelling adults (mean[SD], 68[7] years) participated in this cross-sectional study.

Improving nutrition care and diet intake for hospitalised older people at risk of malnutrition through a nurse-driven mealtime assistance bundle.

Background: Poor dietary intake is common in hospitalised older people. A targeted mealtime intervention is needed to improve nutrition care and dietary intake, especially for those at risk of malnutrition.

Objectives: This quality improvement project designed, implemented and evaluated a mealtime assistance bundle consisting of care measures driven by the hospital nursing team.

Clinical practice for sarcopenia in Asia: Online survey by the Asian Working Group for Sarcopenia.

Objective: This study aimed to (1) investigate the clinical practice for the management of sarcopenia among healthcare professionals in Asia, (2) determine the characteristics of clinical care provided by geriatricians versus by other healthcare professionals, and (3) clarify the awareness of sarcopenia.

Methods: From December 1 to 31, 2022, an online survey was completed by 1990 healthcare professionals in Asia. The survey comprises demographics and institutional characteristics, basic sarcopenia-related details, and sarcopenia-related assessment and treatment details.

Estimating cutpoints of gait speed and sit-to-stand test values for self-reported mobility limitations in a cohort of community-dwelling older adults from Singapore: comparing receiver operating characteristic (ROC) analysis with adjusted predictive modelling.

Objectives: Clinical interpretability of the gait speed and 5-times sit-to-stand (5-STS) tests is commonly established by comparing older adults with and without self-reported mobility limitations (SRML) on gait speed and 5-STS performance, and estimating clinical cutpoints for SRML using the receiver operating characteristics (ROC) method. Accumulating evidence, however, suggests that the adjusted predictive modeling (APM) method may be more appropriate to estimate these interpretational cutpoints. Thus, we aimed to compare, in community-dwelling older adults, gait speed and 5-STS cutpoints estimated using the ROC and APM methods.

Associations of height, weight, and body mass index with handgrip strength: A Bayesian comparison in older adults.

Background & Aims: Handgrip strength is commonly normalized or stratified by body size to define subgroup-specific cut-points and reference limits values. However, it remains unclear which anthropometric variable is most strongly associated with handgrip strength. We aimed to, in older adults with no self-reported mobility limitations, determine whether height, weight, and body mass index (BMI) were meaningfully associated with handgrip strength.

Development and validation of a physical frailty phenotype index-based model to estimate the frailty index.

Background: The conventional count-based physical frailty phenotype (PFP) dichotomizes its criterion predictors-an approach that creates information loss and depends on the availability of population-derived cut-points. This study proposes an alternative approach to computing the PFP by developing and validating a model that uses PFP components to predict the frailty index (FI) in community-dwelling older adults, without the need for predictor dichotomization.

Methods: A sample of 998 community-dwelling older adults (mean [SD], 68 [7] years) participated in this prospective cohort study.

Intrinsic capacity rather than intervention exposure influences reversal to robustness among prefrail community-dwelling older adults: A non-randomized controlled study of a multidomain exercise and nutrition intervention.

Background: The differential risk profiles associated with prefrailty may be attributable to underlying intrinsic capacity (IC).

Objectives: We examine (i) effect of a multi-domain physical exercise and nutrition intervention on pre-frailty reversal in community-dwelling older adults at 1-year, and (ii) whether IC contributes to pre-frailty reversal.

Methods: Prefrail participants in this non-randomized study were invited to attend a 4-month exercise and nutritional intervention following a frailty screen in the community.

Depressive symptoms and malnutrition are associated with other geriatric syndromes and increase risk for 30-Day readmission in hospitalized older adults: a prospective cohort study.

Background: Readmission in older adults is typically complex with multiple contributing factors. We aim to examine how two prevalent and potentially modifiable geriatric conditions - depressive symptoms and malnutrition - relate to other geriatric syndromes and 30-day readmission in hospitalized older adults.

Methods: Consecutive admissions of patients ≥ 65 years to a general medical department were recruited over 16 months.

Screening accuracy of percentage predicted gait speed for prefrailty/frailty in community-dwelling older adults.

Aim: In order to account for the variability in gait speed due to demographic factors, an observed gait speed value can be compared with its predicted value based on age, sex, and body height (observed gait speed divided by predicted gait speed, termed "GS%predicted" henceforth). This study aimed to examine the screening accuracy of an optimal GS%predicted threshold for prefrailty/frailty.

Methods: This cross-sectional study included 998 community-dwelling ambulant participants aged >50 years (mean age = 68 years).

Reference Ranges for Gait Speed and Sit-to-Stand Performance in a Cohort of Mobility-Intact Community-Dwelling Older Adults From Singapore.

Objectives: Slow gait speed and sit-to-stand performance are associated with adverse clinical outcomes in older adults. Identifying older adults with functional performance "below norms" is the first step toward prevention. We aimed to (1) examine the associations of age, body height, and gender with gait speed and sit-to-stand performance and (2) develop subgroup-specific reference ranges in older adults with no self-reported mobility limitations.

Combined Impact of Positive Screen for Sarcopenia and Frailty on Physical Function, Cognition and Nutrition in the Community Dwelling Older Adult.

Background: While sarcopenia and frailty independently contribute to functional impairment and disability, the combined impact resulting from their interplay is unclear. We investigated if functional, physical, cognitive, and nutritional measures were more adversely affected in community-dwelling older adults who were screened positive for both frailty and sarcopenia.

Methods: Using the FRAIL (≥1) and SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls) (≥1) scales for screening, we categorized 200 participants (age, 67.

Association of Monocyte Chemotactic Protein-1 and Dickkopf-1 with Body Composition and Physical Performance in Community-Dwelling Older Adults in Singapore.

Objective: We aim to determine the association of monocyte chemotactic protein-1 (MCP-1) and dickkopft-1 (DKK-1) as potential biomarkers that may predict changes in body composition and physical performance in healthy older adults from Singapore.

Methods: Two-hundred community-dwelling older adults (mean age: 67.9 years; 68.

Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults.

Background: The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants - Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) - with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults.

Methods: This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years.

Elevations in Serum Dickkopf-1 and Disease Progression in Community-Dwelling Older Adults With Mild Cognitive Impairment and Mild-to-Moderate Alzheimer's Disease.

Disruption of Wnt signaling has been implicated in dysfunctional synaptic plasticity, the degree of which correlates with Alzheimer's disease severity. We sought to examine whether serum levels of Dickkopf-1 (Dkk-1), a Wnt antagonist, are associated with global disease progression in older adults with mild cognitive impairment (MCI) and mild-to-moderate AD. We prospectively followed 88 older adults with MCI and mild-to-moderate AD attending a Memory Clinic.

Multidomain Geriatric Screen and Physical Fitness Assessment Identify Prefrailty/Frailty and Potentially Modifiable Risk Factors in Community-Dwelling Older Adults.

Introduction: Frailty begins in middle life and manifests as a decline in functional fitness. We described a model for community frailty screening and factors associated with prefrailty and frailty and fitness measures to distinguish prefrail/frail from robust older adults. We also compared the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight (FRAIL) scale against Fried frailty phenotype and Frailty Index (FI).

Inter-muscular adipose tissue is associated with adipose tissue inflammation and poorer functional performance in central adiposity.

Background: The presence of concomitant sarcopenia and obesity in sarcopenic obesity (SO) confers worse functional, morbidity and mortality outcomes compared to either alone. Excess adiposity and central redistribution of fats are associated with systemic inflammation and ectopic tissue fat infiltration in forms of Intermuscular adipose tissue (IMAT). Our study examines the profile of IMAT across a spectrum of body compositions and associations with physical performance and inflammatory biomarkers including Monocyte Chemoattractant Protein-1 (MCP-1), a novel biomarker of adipose tissue inflammation.

Beyond comanaged inpatient care to community integration: Factors leading to surgical delay in hip fractures and their associated outcomes.

Purpose: Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program.

Methods: This is a prospective cohort study of hip fracture patients aged more than 60 years over 1 year.