Premature frailty, geriatric conditions and multimorbidity among people experiencing homelessness: a cross-sectional observational study in a London hostel
HOUSING CARE AND SUPPORT
Authors: Rogans-Watson, Raphael; Shulman, Caroline; Lewer, Dan; Armstrong, Megan; Hudson, Briony
Abstract
Purpose - The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data. Design/methodology/approach - Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March-April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried's phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England. Findings - A total of 33 people participated with a mean age of 55.7 years (range 38-74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2-14) per study participant far exceeds the average for even the oldest people in the general population. Originality/value - To the best of authors' knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH.
Association between Statin Use and Physical Function among Older Chinese Inpatients with Type 2 Diabetes
JOURNAL OF NUTRITION HEALTH & AGING
Authors: Li, Y.; Yang, X.; Zou, Y.; Li, J.; Sun, Q.; Jing, X.; Yang, M.; Wang, Shuang; Dong, B.
Abstract
Purpose Multiple statin-associated muscle symptoms (SAMS) risk factors usually coexist in a given older diabetic patient, but the association between statin use and physical function in older Asian persons with T2MD remains uncertain. The present study therefore sought to provide insight into this uncertainty through a focused assessment of statin-associated outcomes in Chinese diabetic adults. Design Cross-sectional study. Settings and participants The study included 146 participants with T2MD in the Center of Gerontology and Geriatric, West China Hospital. Measurements The participants received the comprehensive geriatric assessment (CGA). Statin use and other medical data for each patient were determined via assessment of the inpatient hospital information system. Assessments of physical functions included ADLs, IADLs and the Timed "Up and Go" (TUG) test. Multiple regression analyses were then performed in order to determine the relationship between statin utilization and physical function. Results The average age of these 146 participants (32 women, 21.9%) was 80.00 +/- 5.60 years. At enrollment, 78 (53.4%) of the 146 patients were treated with statins. Among the statin users, 48.7% presented with a lack of TUG ability, which was significantly greater than in non-statin users (27.9%). However, the rates of IADL and ADL disabilities did not differ significantly between groups. In a multiple regression analyses, statin use was associated with a three-fold (95% CI 1.06, 9.51) increase in the risk of TUG inability, after adjusted all covariates. Conclusions There was a significant association between statin use and TUG inability in older Chinese inpatients with diabetes.