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Collette-Robert S, Guerville F, Novais T, Pongan E, Morelon E, Vernaudon J, Francq E, Couzi L, Bourdel-Marchasson I, Caillard S, Pszczolinski R, Heitz D, Gilbert T, Garnier-Crussard A. Intrinsic capacity and frailty in older adults with end-stage kidney disease undergoing pre-kidney transplant comprehensive geriatric assessment. J Nutr Health Aging 2024; 28:100236. [PMID: 38643611 DOI: 10.1016/j.jnha.2024.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Frailty has been extensively studied in end-stage kidney disease (ESKD) and kidney transplant (KT) patients. The identification of frailty is useful to predict adverse outcomes among ESKD and KT patients. The recent concept of intrinsic capacity (IC) appears as a good and easy-to-understand tool to screen for and monitor frailty in older adults with ESKD. This study aims to assess the relationships between frailty and IC in older adults with ESKD awaiting KT. DESIGN Cross-sectional study SETTING AND PARTICIPANTS: 236 patients from a day-care geriatric unit undergoing pre-KT geriatric assessment between 2017 and 2022 were included in the main sample, and 151 patients in an independent multicentric replication sample. MEASUREMENTS Frailty was evaluated using the physical frailty phenotype (PFP) and IC measures using the World Health Organization's screening (step 1) and diagnostic (step 2) tools for five IC domains (vitality, locomotion, audition, cognition, psychology). Multivariate regressions were run to assess relationships between PFP and IC domains, adjusted for age, sex, and comorbidities. Analyses were replicated using another independent multicenter cohort including 151 patients with ESKD to confirm the results. RESULTS Impairments in the locomotion, psychology, and vitality IC domains according to WHO screening tools were associated with frailty (odds ratio 9.62 [95% CI 4.09-24.99], 3.19 [95% CI 1.11-8.88], and 3.11 [95% CI 1.32-7.29], respectively). When IC were measured linearly with z-scores, all IC domains except hearing were inversely associated with frailty. In the replication cohort, results were overall similar, with a greater association between psychology domain and frailty. CONCLUSION This study highlights the relationship between frailty and IC in ESKD patients. We assume that IC may be assessed and monitored in ESKD patients, to predict and prevent future frailty, and post-KT adverse outcomes.
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Affiliation(s)
- Sarah Collette-Robert
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France
| | - Florent Guerville
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France; UMR 5536 CNRS/University of Bordeaux, Bordeaux, France; ImmunoConcEpT Lab UMR 5164 CNRS, INSERM ERL 1303, F-33000/University of Bordeaux, Bordeaux, France
| | - Teddy Novais
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Pharmaceutical Unit, Charpennes Hospital, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Elodie Pongan
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Memory Clinical and Research Center of Saint Etienne, Neurology Unit, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Emmanuel Morelon
- Department of Transplantation, Nephrology and Immunology, Hospices Civils de Lyon, Lyon, France
| | - Julien Vernaudon
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Geriatric Medicine Department, Villefranche-Sur-Saône Hospital, 69400 Villefranche-Sur-Saône, France
| | - Eloïse Francq
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France
| | - Lionel Couzi
- Department of Nephrology, Transplantation, Dialysis and Apheresis, CHU Bordeaux, Bordeaux, France
| | - Isabelle Bourdel-Marchasson
- Clinical Gerontology Department, Bordeaux University Hospital, F-33000 Bordeaux, France; UMR 5536 CNRS/University of Bordeaux, Bordeaux, France
| | - Sophie Caillard
- Nephrology-Transplantation Department, University Hospital, 2 Rheumatology Department, University Hospital, Strasbourg, France
| | - Romain Pszczolinski
- Nephrology-Transplantation Department, University Hospital, 2 Rheumatology Department, University Hospital, Strasbourg, France
| | - Damien Heitz
- Unité d'OncoGériatrie, Institut de Cancérologie de Strasbourg Europe, 67033 Strasbourg France
| | - Thomas Gilbert
- Research on Healthcare Professionals and Performance RESHAPE, Inserm U1290, Université Claude Bernard Lyon 1, 69008 Lyon, France; Geriatric Medicine Department, Hospices Civils de Lyon, Groupement Hospitalier Sud, CEDEX, 69495 Pierre-Bénite, France.
| | - Antoine Garnier-Crussard
- Clinical and Research Memory Centre of Lyon, Lyon Institute For Aging, Hospices Civils de Lyon, 69100 Villeurbanne, France; Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Neuropresage Team, Cyceron, 14000 Caen, France.
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Pérez-Castejón JM, Formiga F. [Frailty and intrinsic capacity; from theoretical concept to clinical applicability]. Rev Esp Geriatr Gerontol 2024; 59:101483. [PMID: 38554457 DOI: 10.1016/j.regg.2024.101483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Juan Manuel Pérez-Castejón
- Unidad Docente, Hospital Municipal de Badalona y Centre Sociosanitari El Carme, Badalona Serveis Assistencials. Badalona, Barcelona, España.
| | - Francesc Formiga
- Sección de Geriatría, Servicio de Medicina Interna, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
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Yıldırım Ayaz E, Dincer B, Mete E, Kaygusuz Benli R, Cinbaz G, Karacan E, Cankül A, Mesci B. Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals. Arch Gerontol Geriatr 2024; 118:105281. [PMID: 38056100 DOI: 10.1016/j.archger.2023.105281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/17/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Our study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC). METHODS The study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745. RESULTS 90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025). CONCLUSION In this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.
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Affiliation(s)
- Elif Yıldırım Ayaz
- University of Health Sciences, Sultan 2. Abdülhamid Han Training and Research Hospital, Internal Medicine Clinic, Selimiye, Tıbbiye Cd, 34668 Üsküdar, İstanbul Turkey.
| | - Berna Dincer
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Internal Medicine Nursing, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Emel Mete
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Reyhan Kaygusuz Benli
- Demiroglu Science University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Yazarlar St. No:17, 34394 Esentepe Şişli, İstanbul, Turkey
| | - Gülser Cinbaz
- Istanbul Medeniyet University Faculty of Health Sciences, Department of Physiothetapy and Rehabilitation, Kartal Cevizli Yerleşkesi, Atalar Mh. Şehit Hakan Kurban Cd., 34862 Kartal, İstanbul, Turkey
| | - Esra Karacan
- Yeditepe University, Health Science Faculty, Department of Physiothetapy and Rehabilitation, Kayışdağı, İnönü Mahallesi, Kayışdağı Cd., 34755 Ataşehir, İstanbul, Turkey
| | - Ayşegül Cankül
- Medipol University Hospital, Internal Medicine and Onkology Clinic, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, 34214, Bağcılar, İstanbul, Turkey
| | - Banu Mesci
- Istanbul Medeniyet University Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Internal Medicine Clinic, Eğitim Mah. Fahrettin Kerim Gökay, Caddesi Kadıköy, İstanbul, Turkey
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Woo BKP, Woo GCL. Digital media for sleep education to Chinese immigrants. Sleep Med 2023; 110:258. [PMID: 37666050 DOI: 10.1016/j.sleep.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023]
Affiliation(s)
- Benjamin K P Woo
- Chinese American Health Promotion Laboratory, University of California, Los Angeles, CA, USA; Department of Podiatric Medicine and Surgery, Western University of Health Sciences, Pomona, CA, USA.
| | - Gina C L Woo
- Chinese American Health Promotion Laboratory, University of California, Los Angeles, CA, USA
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