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- Ekerstad, Niklas, et al.
(author)
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Clinical frailty scale – skörhet är ett sätt att skatta biologisk ålder
- 2022
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In: Lakartidningen. - 0023-7205. ; 119, s. 1-5
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Research review (peer-reviewed)abstract
- The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
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| 2. |
- Ekerstad, Niklas, 1969-, et al.
(author)
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Clinical frailty scale – skörhet ärett sätt att skatta biologisk ålder : [Clinical Frailty Scale - a proxy estimate of biological age]
- 2022
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In: Läkartidningen. - : Sveriges Läkarforbund. - 0023-7205 .- 1652-7518. ; 119
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Research review (peer-reviewed)abstract
- The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
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| 3. |
- Lindh Mazya, Amelie, et al.
(author)
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Discordance in Frailty Measures in Old Community Dwelling People with Multimorbidity - A Cross-Sectional Study
- 2023
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In: Clinical Interventions in Aging. - 1178-1998. ; 18, s. 1607-1618
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Journal article (peer-reviewed)abstract
- PURPOSE: Assessment of frailty is a key method to identify older people in need of holistic care. However, agreement between different frailty instrument varies. Thus, groups classified as frail by different instruments are not completely overlapping. This study evaluated differences in sociodemographic factors, cognition, functional status, and quality of life between older persons with multimorbidity who were discordantly classified by five different frailty instruments, with focus on the Clinical Frailty Scale (CFS) and Fried's Frailty Phenotype (FP).PARTICIPANTS AND METHODS: This was a cross-sectional study in a community-dwelling setting. Inclusion criteria were as follows: ≥75 years old, ≥3 visits to the emergency department the past 18 months, and ≥3 diagnoses according to ICD-10. 450 participants were included. Frailty was assessed by CFS, FP, Short Physical Performance Battery (SPPB), Grip Strength and Walking Speed.RESULTS: 385 participants had data on all frailty instruments. Prevalence of frailty ranged from 34% (CFS) to 75% (SPPB). Nine percent of participants were non-frail by all instruments, 20% were frail by all instruments and 71% had discordant frailty classifications. Those who were frail according to CFS but not by the other instruments had lower cognition and functional status. Those who were frail according to FP but not CFS were, to a larger extent, women, lived alone, had higher cognitive ability and functional status.CONCLUSION: The CFS might not identify physically frail women in older community-dwelling people with multimorbidity. They could thus be at risk of not be given the attention their frail condition need.
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| 4. |
- Mazya, Amelie Lindh, et al.
(author)
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Translation and Validation of the Swedish Version of the Tilburg Frailty Indicator
- 2023
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In: Healthcare. - 2227-9032. ; 11:16, s. 1-14
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Journal article (peer-reviewed)abstract
- The Tilburg Frailty Indicator (TFI) is a questionnaire with 15 questions designed for screening for frailty in community-dwelling older people. TFI has a multidimensional approach to frailty, including physical, psychological, and social dimensions. The aim of this study was to translate TFI into Swedish and study its psychometric properties in community-dwelling older people with multimorbidity. A cross-sectional study of individuals 75 years and older, with ≥3 diagnoses of the ICD-10 and ≥3 visits to the Emergency Department in the past 18 months. International guidelines for back-translation were followed. Psychometric properties of the TFI were examined by determining the reliability (inter-item correlations, internal consistency, test-retest) and validity (concurrent, construct, structural). A total of 315 participants (57.8% women) were included, and the mean age was 83.3 years. The reliability coefficient KR-20 was 0.69 for the total sum. A total of 39 individuals were re-tested, and the weighted kappa was 0.7. TFI correlated moderately with other frailty measures. The individual items correlated with alternative measures mostly as expected. In the confirmatory factor analysis (CFA), a three-factor model fitted the data better than a one-factor model. We found evidence for adequate reliability and validity of the Swedish TFI and potential for improvements.
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| 5. |
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| 6. |
- Behm, Mikaela, 1986-, et al.
(author)
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Synaptic expression and regulation of miRNA editing in the brain
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Other publication (other academic/artistic)abstract
- In the brain, sophisticated networks of RNA regulatory events tightly control gene expression in order to achieve proper brain function. We and others have previously shown that several miRNAs, encoded within the miR-379-410 cluster, are subjected to A-to-I RNA editing. In the present study we conclude these edited miRNAs to be transcribed as a single long consecutive transcript, however the maturation into functional forms of miRNAs is regulated individually. In seven of the miRNAs, subjected to editing, we analyze how editing relates to miRNA maturation. Of particular interest has been maturation of miR-381-3p and miR-376b-3p, both important for neuronal plasticity, dendrite outgrowth and neuronal homeostasis. Most of the edited miRNAs from the cluster, are highly edited in their unprocessed primary transcript, including miR-381-3p and miR-376b-3p. However, editing in miR-381-3p is almost entirely absent in the mature form, while editing is increased in the mature form of miR-376b-3p compared to the primary transcript. We propose that ADAR1 positively influences the maturation of pri-miR-381 in an editing independent manner. In pri-miR-376b we hypothesize that ADAR1 and ADAR2 competes for editing, and while ADAR2 inhibits miRNA maturation, ADAR1 editing is frequently present in the mature miR-376b-3p. We further show that miR-381-3p and miR-376b-3p regulate the dendritically expressed Pumilio 2 (Pum2) protein. By next generation RNA sequencing (NGS RNA-seq) on purified synaptoneurosomes, we show that miR-381-3p is highly expressed at the synapse, suggesting its functional role in locally regulating Pum2. Furthermore, we identify a set of highly expressed miRNAs at the synapse, which may act locally to target synaptic mRNAs.
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| 9. |
- Dahlqvist, Jenny, et al.
(author)
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Does comprehensive geriatric assessment (CGA) in an outpatient care setting affect the causes of death and the quality of palliative care? A subanalysis of the age-FIT study
- 2019
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In: European Geriatric Medicine. - : Springer Science and Business Media LLC. - 1878-7649 .- 1878-7657. ; 10:3, s. 455-462
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Journal article (peer-reviewed)abstract
- Purpose: The purposes of this study were to retrospectively study whether comprehensive geriatric assessment (CGA) given to community-dwelling old patients with high health care usage has effects regarding: (1) the cause of death and (2) the quality of the provided palliative care when compared to patients without CGA-based care. Method: This study includes secondary data from a randomised controlled trial (RCT) with 382 participants that took place in the periods 2011–2013. The present study examines all electronical medical records (EMR) from the deceased patients in the original study regarding cause of death [intervention group (IG) N = 51/control group (CG) N = 66] and quality of palliative care (IG N = 33/CG N = 41). Descriptive and comparative statistics were produced and the significance level was set at p < 0.05. Results: The causes of death in both groups were dominated by cardiovascular and cerebrovascular diseases with no statistical difference between the groups. Patients in the intervention group had a higher degree of support from specialised palliative care teams than had the control group (p = 0.01). Conclusion: The present study in an outpatient context cannot prove any effects of CGA on causes of death. The study shows that CGA in outpatient care means a higher rate of specialised palliative care, but the study cannot show any effects on the palliative quality parameters measured. Further studies with statistical power are needed.
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