The feasibility and acceptability of assessing and managing sarcopenia and frailty among older people with upper limb fracture
The feasibility and acceptability of assessing and managing sarcopenia and frailty among older people with upper limb fracture
Background: Sarcopenia and frailty are associated with increased risk of falls and fractures. This study evaluated the feasibility of assessing sarcopenia and frailty among older people attending fracture clinics.
Methods: Patients aged 65+ years with an arm fracture attending fracture clinics in one UK city were recruited. Sarcopenia was assessed using gait speed, grip strength, skeletal muscle mass index SMI, SARC-F questionnaire, the European Working Group on Sarcopenia in Older People (EWGSOP) I and II criteria. Frailty was assessed using Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was calculated against the EWGSOP II criteria (sarcopenia) and FFP (frailty). Patients identified to have either condition were referred for Comprehensive Geriatric Assessment (CGA). Interviews with 13 patients and nine staff explored the acceptability of this process.
Results: 100 patients (Mean age 75 years) were recruited. Most sarcopenia and frailty assessments were quick with complete data collection and were acceptable to patients and staff. Sarcopenia was identified among 4% -39% participants depending on the tool and frailty among 9-25%. Both conditions were more common among men than women with all tools. The SARC-F and PRISMA-7 had the best sensitivity (100% and 93% respectively) and specificity (96% and 87%). CGA among 80% of referred participants led to three interventions per participant (e.g. medication changes, investigations).
Conclusions: SARC-F and PRISMA-7 are recommended for use in fracture clinics to screen for sarcopenia and frailty.
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Mullee, Mark
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Cox, Natalie
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Russell, Cynthia
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Baxter, Mark
3415aa9a-8eb0-454e-9b7a-dadb1ce4e5c6
Tilley, Simon
cd468907-2c35-4f52-a817-6ad0c7977608
Yao, Guiqing Lily
93c8b843-35ee-4a63-8486-98efa85cb7f5
Zhu, Shihua
13511f9c-151c-483c-9dfd-2da13421db5c
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
January 2022
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Cox, Natalie
dfdfbc5f-41b8-4329-a4b5-87b6e93aa09e
Russell, Cynthia
7004bba9-a609-47ed-9b7c-898eb3f2caa1
Baxter, Mark
3415aa9a-8eb0-454e-9b7a-dadb1ce4e5c6
Tilley, Simon
cd468907-2c35-4f52-a817-6ad0c7977608
Yao, Guiqing Lily
93c8b843-35ee-4a63-8486-98efa85cb7f5
Zhu, Shihua
13511f9c-151c-483c-9dfd-2da13421db5c
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Ibrahim, Kinda, Mullee, Mark, Cox, Natalie, Russell, Cynthia, Baxter, Mark, Tilley, Simon, Yao, Guiqing Lily, Zhu, Shihua and Roberts, Helen
(2022)
The feasibility and acceptability of assessing and managing sarcopenia and frailty among older people with upper limb fracture.
Age and Ageing, 51 (1), [afab252].
(doi:10.1093/ageing/afab252).
Abstract
Background: Sarcopenia and frailty are associated with increased risk of falls and fractures. This study evaluated the feasibility of assessing sarcopenia and frailty among older people attending fracture clinics.
Methods: Patients aged 65+ years with an arm fracture attending fracture clinics in one UK city were recruited. Sarcopenia was assessed using gait speed, grip strength, skeletal muscle mass index SMI, SARC-F questionnaire, the European Working Group on Sarcopenia in Older People (EWGSOP) I and II criteria. Frailty was assessed using Fried Frailty Phenotype (FFP), FRAIL scale, PRISMA-7, electronic Frailty Index (e-FI), Clinical Frailty Score (CFS), and Study of Osteoporotic Fracture (SOF). The sensitivity and specificity of each tool was calculated against the EWGSOP II criteria (sarcopenia) and FFP (frailty). Patients identified to have either condition were referred for Comprehensive Geriatric Assessment (CGA). Interviews with 13 patients and nine staff explored the acceptability of this process.
Results: 100 patients (Mean age 75 years) were recruited. Most sarcopenia and frailty assessments were quick with complete data collection and were acceptable to patients and staff. Sarcopenia was identified among 4% -39% participants depending on the tool and frailty among 9-25%. Both conditions were more common among men than women with all tools. The SARC-F and PRISMA-7 had the best sensitivity (100% and 93% respectively) and specificity (96% and 87%). CGA among 80% of referred participants led to three interventions per participant (e.g. medication changes, investigations).
Conclusions: SARC-F and PRISMA-7 are recommended for use in fracture clinics to screen for sarcopenia and frailty.
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More information
Accepted/In Press date: 11 October 2021
e-pub ahead of print date: 30 December 2021
Published date: January 2022
Additional Information:
This work was supported by the National Institute of Health Research (NIHR) Research for Patient Benefit (RfPB) program grant number (PB-PG-0317-20043). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. HCR and KI received support from the NIHR Applied Research Collaboration (ARC) Wessex and the University of Southampton. HCR and NC received support from the NIHR Southampton Biomedical Research Centre.
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Local EPrints ID: 452625
URI: http://eprints.soton.ac.uk/id/eprint/452625
ISSN: 0002-0729
PURE UUID: 078eb17d-8589-491f-afe7-db88de672e27
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Date deposited: 11 Dec 2021 11:29
Last modified: 12 Nov 2024 05:05
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Author:
Natalie Cox
Author:
Cynthia Russell
Author:
Mark Baxter
Author:
Simon Tilley
Author:
Guiqing Lily Yao
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