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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
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.
0002-0729
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Cox, Natalie, Jayne
b59c2eb7-cfb2-4b2d-88cf-314240ddc557
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
54f027ad-0599-4dd4-bdbf-b9307841a294
Mullee, Mark
fd3f91c3-5e95-4f56-8d73-260824eeb362
Cox, Natalie, Jayne
b59c2eb7-cfb2-4b2d-88cf-314240ddc557
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, Jayne, Russell, Cynthia, Baxter, Mark, Tilley, Simon, Yao, Guiqing Lily, Zhu, Shihua and Roberts, Helen (2021) The feasibility and acceptability of assessing and managing sarcopenia and frailty among older people with upper limb fracture. Age and Ageing. (doi:10.1093/ageing/afab252).

Record type: Article

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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Accepted/In Press date: 11 October 2021
Published date: 30 December 2021
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.

Identifiers

Local EPrints ID: 452625
URI: http://eprints.soton.ac.uk/id/eprint/452625
ISSN: 0002-0729
PURE UUID: 078eb17d-8589-491f-afe7-db88de672e27
ORCID for Kinda Ibrahim: ORCID iD orcid.org/0000-0001-5709-3867
ORCID for Natalie, Jayne Cox: ORCID iD orcid.org/0000-0002-4297-1206
ORCID for Helen Roberts: ORCID iD orcid.org/0000-0002-5291-1880

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Date deposited: 11 Dec 2021 11:29
Last modified: 12 Apr 2022 01:55

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Contributors

Author: Kinda Ibrahim ORCID iD
Author: Mark Mullee
Author: Natalie, Jayne Cox ORCID iD
Author: Cynthia Russell
Author: Mark Baxter
Author: Simon Tilley
Author: Guiqing Lily Yao
Author: Shihua Zhu
Author: Helen Roberts ORCID iD

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