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Chenhuichen C, O'Halloran AM, Lang D, Kenny RA, Romero-Ortuno R. The lived experience of frailty: beyond classification and towards a holistic understanding of health. Eur Geriatr Med 2024; 15:435-444. [PMID: 38196075 PMCID: PMC10997539 DOI: 10.1007/s41999-023-00909-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE Frailty is characterised by decreased physiological reserves and vulnerability to stressors. Although scales, such as the Fried's Frailty Phenotype (FP), Frailty Index (FI), and Clinical Frailty Scale (CFS), are used to identify frailty, the lived experience of frailty remains understudied. METHODS This cross-sectional observational research involved participants aged 65 years and older from Wave 1 of The Irish Longitudinal Study on Ageing (TILDA). Participants were categorised into four independent groups: three frail groups based on the aforementioned scales and a non-frail group. Quantitative variables, including self-rated health, CASP-19 quality-of-life score, and frequency of social activities, were analysed and described. RESULTS The study encompassed 1999 participants with an average age of 72 years, of whom 51% were women. FP exclusively identified 1.6% as frail (n = 32), FI 11.7% (n = 233), and CFS 6.8% (n = 135). More than 60% of all those classified as frail reported their health as good, very good, or excellent, with the lowest proportion (64%) being among frail by FI participants. Frail by FI participants exhibited the lowest mean average CASP-19 score, yet it remained relatively high at 39 out of 57 points. Over 77% of all frail individuals engaged in active leisure activities at least once a month. CONCLUSION This study underscores the need to comprehend frailty holistically beyond its mere identification. It challenges the prevailing belief that frailty inevitably leads to impaired quality of life and limited social engagement. The findings advocate for a reassessment of how both the general public and healthcare professionals perceive frailty.
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Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
| | - Deirdre Lang
- National Frailty Education Programme, Office of the Nursing & Midwifery Service Director (ONMSD), Health Service Executive, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.
- Discipline of Medical Gerontology, 6th Floor, School of Medicine, Trinity College, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
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Chenhuichen C, Marín-Epelde I, Ramón-Espinoza F, Sánchez-Latorre M, Gonzales Montejo NJ, Pozo Vico A, Librero López J, Casas-Herrero A. [Epidemiological, clinical, and functional characteristics of patients older than 75 years admitted to a tertiary hospital during the first wave of the SARS-CoV-2 pandemic]. Rev Esp Geriatr Gerontol 2024; 59:101449. [PMID: 38064873 DOI: 10.1016/j.regg.2023.101449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND The objective of the present study is to analyze the epidemiological, clinical and functional characteristics of patients admitted to the University Hospital of Navarra due to SARS-CoV-2 infection, as well as the predictors of mortality, during the first wave of the pandemic caused by this virus. METHODOLOGY An observational, retrospective study was performed, including all hospitalized patients older than 75 years. Information has been obtained on multiple variables, among which it is worth mentioning previous geriatric syndromes or those that have appeared during hospitalization, or past medical history considered relevant in SARS-CoV-2 infection. A descriptive analysis of the data, comparisons according to various factors of interest and multivariate analysis to analyze factors associated with mortality were carried out. RESULTS Data have been obtained from a total of 426 patients with a mean age of 83.2 years (52.6% men). 34.7% died in hospital and 4.5% within 1 month after hospital discharge. The factors related to mortality were: worse baseline functional status, chronic kidney disease, and fever or dyspnea as forms of presentation. The most frequent typical symptoms were: fever, dyspnea, cough, asthenia and hyporexia. Up to 42.1% presented delirium as a symptom of atypical onset. We observed a functional deterioration that was not recover after a month of follow-up (baseline Barthel index 81.12; 70.08 at discharge; 75.55 after a month). CONCLUSIONS SARS-CoV-2 infection has caused high mortality rates in older adults. In this age group, the atypical presentation of this disease and functional deterioration during hospitalization are frequent. In the present study, a worse previous functional status has been identified as a predictor of mortality. More studies are needed to evaluate the impact that the disease and hospitalization have on the older patient, with the aim of implementing preventive, diagnostic and therapeutic measures that are necessary to avoid functional deterioration and adverse health events related to it.
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Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | - Itxaso Marín-Epelde
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | | | - Marina Sánchez-Latorre
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | | | - Ana Pozo Vico
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España
| | - Julián Librero López
- Biomedical Research Centre of the Government of Navarre (Navarrabiomed), , Pamplona, Navarra, España
| | - Alvaro Casas-Herrero
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, España; Biomedical Research Centre of the Government of Navarre (Navarrabiomed), , Pamplona, Navarra, España; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, España; Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, España.
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Doherty H, Jennings AH, Kocka M, Neichel A, Scauso J, Lionetti E, Chenhuichen C, Romero-Ortuno R. A Narrative Review of the Utilisation of the SHARE Frailty Instruments (SHARE-FI and SHARE-FI75+) in the Literature. J Frailty Sarcopenia Falls 2023; 8:221-229. [PMID: 38046443 PMCID: PMC10690129 DOI: 10.22540/jfsf-08-221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 12/05/2023] Open
Abstract
This narrative literature review aimed to examine the utilisation of the Survey of Health, Ageing and Retirement in Europe (SHARE) frailty instruments: SHARE-FI and SHARE-FI75+. We used the Google Scholar "cited by" function (accessed on February 20th, 2023) to identify all citations of the original SHARE-FI and SHARE-FI75+ studies. Included articles were categorised into four themes: epidemiological studies (prevalence and associated factors); associations with geriatric syndromes, diseases and health outcomes; randomised clinical trials (RCTs); and expert consensus and practice guidelines. Of 529 articles screened (446 citing SHARE-FI and 83 citing SHARE-FI75+), 64 (12.1%) were included. Sixteen (25.0%) were epidemiological; 35 (54.7%) described associations; 10 (15.6%) were RCTs; and 3 (4.7%) were expert consensus or practice guidelines. Frailty was associated with older age; female sex; higher morbidity; lower education; social isolation; worse nutrition and mobility; rheumatological, cardiovascular, and endocrine diseases; and greater healthcare utilisation and mortality. SHARE-FI was used in RCTs as entry criterion, controlling variable, and intervention outcome. SHARE-FI and SHARE-FI75+ have been recommended to aid the management of atrial fibrillation anticoagulation and hypertension, respectively. SHARE-FI and SHARE-FI75+, two open access phenotypical frailty measurement tools, have been utilised for a range of purposes, and mostly in epidemiological/associational studies.
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Affiliation(s)
- Helen Doherty
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Matej Kocka
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | | | - Elena Lionetti
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Chenhui Chenhuichen
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Geriatric Medicine Service, University Hospital of Navarra, Pamplona, Spain
| | - Roman Romero-Ortuno
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
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Chenhuichen C, González-Senac NM. Technology enabled care and older adults: Where are we at? Rev Esp Geriatr Gerontol 2023; 58:101384. [PMID: 37481840 DOI: 10.1016/j.regg.2023.101384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, Spain.
| | - Nicolás M González-Senac
- Geriatrics Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain; Instituto de Investigación Sanitaria Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Chenhuichen C, Cabello-Olmo M, Barajas M, Izquierdo M, Ramírez-Vélez R, Zambom-Ferraresi F, Martínez-Velilla N. Impact of probiotics and prebiotics in the modulation of the major events of the aging process: A systematic review of randomized controlled trials. Exp Gerontol 2022; 164:111809. [DOI: 10.1016/j.exger.2022.111809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022]
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Chenhuichen C, Sánchez-Latorre M, Hernández-Amador ÁZ, Garaioa-Aramburu KJ, de Asteasu MLS, Martínez-Velilla N. Cambios en perfil clínico de pacientes hospitalizados en una unidad geriátrica de agudos tras la pandemia COVID-19. Rev Esp Geriatr Gerontol 2022; 57:195-196. [PMID: 35570066 PMCID: PMC9023322 DOI: 10.1016/j.regg.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/23/2022] [Accepted: 03/16/2022] [Indexed: 11/24/2022]
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Chenhuichen C, Sánchez-Latorre M, Zubiría JM, Martínez-Velilla N. [Debut of type1 diabetes mellitus in a 91-year-old man]. Rev Esp Geriatr Gerontol 2021; 56:111-112. [PMID: 33494931 DOI: 10.1016/j.regg.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Chenhui Chenhuichen
- Servicio de Geriatría, Complejo Hospitalario de Navarra (CHN), Pamplona, España.
| | | | - Juan Manuel Zubiría
- Servicio de Endocrinología y Nutrición, Complejo Hospitalario de Navarra (CHN), Pamplona, España
| | - Nicolás Martínez-Velilla
- Servicio de Geriatría, Complejo Hospitalario de Navarra (CHN), Pamplona, España; Navarrabiomed, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, España; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud CarlosIII, Madrid, España
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