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The Clinical Frailty Scale: Do Staff Agree?
Open AccessArticle

Inter-Relationships between Frailty, Sarcopenia, Undernutrition and Dysphagia in Older People Who Are Admitted to Acute Frailty and Medical Wards: Is There an Older Adult Quartet?

1
Department Geriatric Medicine, Lewisham and Greenwich NHS Trust, London SE13 6LH, UK
2
School of Health Science, University of Greenwich, London SE9 2UG, UK
3
Department Medicine, Royal Halamshire Hospital, Sheffield S10 2JF, UK
4
Department Medicine, St Thomas’ Hospital, London SE1 7EH, UK
5
Department Acute Medicine, King’s College Hospital, London SE5 9RS, UK
*
Author to whom correspondence should be addressed.
Geriatrics 2020, 5(3), 41; https://doi.org/10.3390/geriatrics5030041
Received: 4 May 2020 / Revised: 17 June 2020 / Accepted: 23 June 2020 / Published: 30 June 2020
Introduction: With increasing age the prevalence of frailty, sarcopenia, undernutrition and dysphagia increases. These are all independent markers of outcome. This study explores the prevalence of these four and explores relationships between them. Methods: A convenience sample of 122 patients admitted to acute medical and frailty wards were recruited. Each was assessed using appropriate screening tools; Clinical Frailty Score (CFS) for frailty, SARC-F for sarcopenia, Nutritional Risk Tool (NRT) for nutritional status and 4QT for dysphagia. Results: The mean age of the participants was 80.53 years (65–99 years), and 50.37% (68) were female. Overall, 111 of the 122 (91.0%) reported the presence of at least one of the quartet. The median CFS was 5 (1–9), with 84 patients (68.9%) having a score of ≥5 (moderate or severely frail); The median SARC-F was 5 (0–10), with 64 patients (52.5%) having a score of ≥5; The median NRT was 0 (0–8) and 33 patients (27.0%) scored ≥ 1. A total of 77 patients (63.1%) reported no difficulty with swallowing/dysphagia (4QT ≥ 1) and 29 (23.7%) had only one factor. Sixteen patients (13.1%) had all four. There was a significant correlation between nutritional status and dysphagia, but not with frailty or sarcopenia. There were significant correlations between frailty and both sarcopenia and dysphagia. Conclusions: In our sample of acute medical and frailty ward patients, there was a much higher prevalence than expected (91%) of either: frailty, sarcopenia, undernutrition or dysphagia. The prevalence of all four was present in 13% of patients. We suggest that frailty, sarcopenia, nutritional risk and dysphagia comprise an “Older Adult Quartet”. Further study is required to investigate the effect of the “Older Adult Quartet” on morbidity and mortality. View Full-Text
Keywords: dysphagia; nutrition; frailty; sarcopenia dysphagia; nutrition; frailty; sarcopenia
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Smithard, D.; Hansjee, D.; Henry, D.; Mitchell, L.; Sabaharwal, A.; Salkeld, J.; Yeung, E.; Younus, O.; Swaine, I. Inter-Relationships between Frailty, Sarcopenia, Undernutrition and Dysphagia in Older People Who Are Admitted to Acute Frailty and Medical Wards: Is There an Older Adult Quartet? Geriatrics 2020, 5, 41.

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