Background: Frailty represents a state of multisystem impairment that may adversely impact people presenting with chronic limb-threatening ischemia (CLTI) and diabetes-related foot ulcers (DFUs). The aim of this systematic review was to explore the association between frailty and outcomes from CLTI and DFUs.
Methods: We performed a systematic literature search of electronic databases to find studies using a validated measure of frailty in individuals with CLTI and/or DFUs. The primary outcomes were the impact of frailty on the severity of initial clinical presentation and unfavorable follow-up outcomes including readmissions, major limb amputation, cardiovascular events, revascularization, and wound healing.
Results: Ten cohort studies were included. Two studies had a low risk of bias, 1 was unable to be assessed, 5 had moderate risk of bias, and 2 high risk of bias. The prevalence of frailty in people presenting with CLTI ranged from 27% to 88% and was 71% in people with DFUs. The presence of frailty in both people with CLTI and DFUs was associated with substantially increased severity at presentation (severity of ischemia and tissue loss) and poorer outcomes at follow-up (risk of readmission, limb amputation, and all-cause mortality).
Conclusions: The presence of frailty in both people with CLTI and DFUs is likely associated with substantially higher complexity at presentation followed by a greater risk for readmission, amputation, and death during follow-up. Heterogeneity in the tools used to screen for frailty, poor definition of frailty, and unclear evaluation of exposure and outcomes limit further interpretation of findings.
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http://dx.doi.org/10.1016/j.avsg.2022.09.057 | DOI Listing |
Front Public Health
December 2024
School of Nursing, University of South China, Hengyang, China.
Objective: This study aimed to conduct a systematic review and meta-analysis, assessing the pooled prevalence and influencing factors of oral frailty in older people to assist healthcare professionals in enhancing their understanding of this condition and formulating efficient interventions.
Methods: This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) guidelines. We searched PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, ProQuest, the National Knowledge Infrastructure (CNKI), WAN FANG DATA, VIP Information, SinoMed and Scopus for literature published in English or Chinese from inception to June 19, 2024.
BMC Geriatr
December 2024
School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, People's Republic of China.
Background: Evidence on the association of dynamic change in frailty index (FI) with risk of all-cause mortality in the older Chinese population is limited. This study aimed to explore the association of 3-year change in FI with risk of all-cause mortality in an older Chinese population.
Methods: We analyzed the data of 4969 participants from the Chinese Longitudinal Healthy Longevity Survey.
BMJ Support Palliat Care
December 2024
Wolfson Palliative Care Research Centre, University of Hull, Hull, UK.
Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general frailty and will have a limited prognosis.
View Article and Find Full Text PDFJ Clin Epidemiol
December 2024
Department of Internal Medicine, Section of Geriatrics and Gerontology, Leiden University Medical Center, Leiden, The Netherlands.
Objective: During the COVID-19 pandemic, dynamic factors such as governmental policies, improved treatment and prevention options and viral mutations changed the incidence of outcomes and possibly changed the relation between predictors and outcomes. The aim of the present study was to assess whether the dynamic context of the pandemic influenced the predictive performance of mortality predictions over time in older patients hospitalised for COVID-19.
Study Design And Setting: The COVID-OLD study, a multicentre cohort study in the Netherlands, included COVID-19 patients aged 70 years and older hospitalised during the first (early 2020), second (late 2020), third (late 2021) or fourth wave (early 2022).
Clin Gerontol
December 2024
School of Nursing, Peking University, Beijing, China.
Objectives: To investigate whether baseline depressive symptoms impacted the effectiveness of an exercise intervention among (pre)frail older adults.
Methods: This is a subanalysis of a stepped-wedge cluster randomized trial implementing an exercise intervention, with an application of the integration of the Health Belief Model, Theory of Planned Behavior, and Health Action Process Approach, among 149 community-dwelling (pre)frail older adults. The intervention effectiveness was examined by baseline depressive symptoms (depressive symptoms ( = 40) and non-depressive symptoms ( = 109).
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