Ability of Comprehensive Geriatric Assessment to Detect Frailty

Background and Aim of the Work: Frailty is a state of reduced physiological reserve associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. This work assessed the ability of comprehensive geriatric assessment to detect frailty in elderly patients. Subjects and Methods: A total number of 104 elderly patients (above 60 years old) were included in this study and they were subjected to a comprehensive geriatric assessment (CGA) including: (history and full clinical examination, Mini mental status examination (MMSE), Geriatric depression scale (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008, each group included 52 patients. Results: There were no significant differences between the two groups regarding age gender or smoking habits. But there was higher percentage of ADL, IADL dependence in addition to higher incidence of depression and cognitive impairment among frail cases. Conclusion: Comprehensive geriatric assessment can be used to detect frailty and its associated impairment and comorbidities.

Relationship between bone mineral density, coronary risk factors, C-reactive protein, and Insulin growth factor in frail elderly

Objective: This study aimed to explore the relation between bone mineral density (BMD), inflammation, coronary risk factors, and Insulin growth factor (IGF) in frail elderly. Design: A casecontrol study. Setting: Ain Shams University Hospital Cairo, Egypt. Participants: Ninety aged 60 years and above;sixty frail (30 males and 30 females;mean age 70.03 ± 8.10) and thirty matched controls (15 males and 15 females;mean age 69.07 ± 5.93). Measurements: History, examination, comprehensive geriatric assessment, measurement of BMD, and laboratory investigations including;high sensitivity C-reactive protein (hs-CRP) glycated haemoglobin, IGF, lowdensity lipoprotein (LDL), high-density lipoprotein, total cholesterol, and triglycerides. Results: The frail group had significantly lower levels of triglycerides and LDL, hs-CRP and glycated haemoglobin levels were significantly higher (P < 0.001), and BMD and IGF levels were significantly lower when compared with the control group (P < 0.00*, P = 0.05) respectively. We also found that BMD had a significant positive linear correlation with IGF and negative correlation with age. Conclusion: Frailty was associated with low BMD, lower triglycerides & LDL levels, and higher hsCRP levels. A borderline significance was found between IGF levels and frailty. A positive correlation was found between BMD and IGF in frail.

Homocystiene and C-Reactive Protein in Detection of Frailty

Background and Aim of the Work: Frailty is a state of reduced physiological reserve and is associated with increased susceptibility to disability. It is associated with a high morbidity and mortality. The aim of this work is to assess the association between the levels of homocystiene and C-reactive protein and frailty and to examine the ability of homocystiene as a new marker to detect frailty. Subjects and Methods: A total number of 104 elderly subjects (above 60 years old) were included in this study and they were subjected to history, examination, comprehensive geriatric assessment, and laboratory investigations including: C-reactive protein (CRP) and Homocystiene (Hcy). The patients were divided into frail and non-frail groups using Fried’s criteria as applied by Avila-Funes et al., 2008 and each group included 52 patients. Results: There was no significant difference between the two groups as regards age gender or smoking habits. But there were higher levels of CRP (>10 mg/dl) and homocystiene (>12 mmol/l) among frail cases and by comparing both homocystiene was more sensitive in detection of frailty. Conclusion: Frailty was associated with eleveted homocystiene and CRP and homocystiene is more specific than CRP in detection of frailty.