Background: This study aimed to determine the prevalence and risk factors for sarcopenia and severe sarcopenia among urban community-dwelling adults in Thailand, using the Asian Working Group for Sarcopenia (AWGS-2019) criteria. Methods: This cross-sectional study comprising 892 older adults aged > 60 years analyzed data from a cohort study (Bangkok Falls study; 2019–2021). The appendicular skeletal muscle mass was evaluated using the Bioelectrical Impedance Analysis (BIA) method. Physical performance and muscle strength were evaluated using the five-time sit-to-stand and handgrip strength tests, respectively. Logistic regression was used to determine the factors associated with sarcopenia. Results: The prevalence rates of sarcopenia and severe sarcopenia were 22.2% and 9.4%, respectively. Age ≥ 70 years (adjusted odds ratio (aOR), 2.40; 95% confidence interval (CI), 1.67–3.45), body mass index (BMI) of < 18.5 kg/m² (aOR, 8.79; 95% CI, 4.44–17.39), Mini Nutritional Assessment (MNA) score of < 24 (aOR, 1.75; 95% CI, 1.24–2.48), and a six-item cognitive screening test score of ≥ 8 (aOR, 1.52; 95% CI, 1.08–12.15) were associated with sarcopenia. Likewise, age ≥ 70 years, BMI < 18.5 kg/m², and an MNA score of < 24 predicted severe sarcopenia. Conclusion: One-third of the urban community-dwelling older Thai adults had sarcopenia or severe sarcopenia. The age ≥ 70 years, low BMI, and inadequate nutrition increased the risk of both sarcopenia and severe sarcopenia while impaired cognitive functions predicted only sarcopenia in this population.

Introduction: Falls are a frequent reason geriatric patients visit the emergency department (ED). To help providers, the Geriatric Emergency Department Guidelines were created to establish a standard of care for geriatric patients in the ED. We conducted a survey of emergency providers to assess 1) their knowledge of fall epidemiology and the geriatric ED guidelines; 2) their current ED practice for geriatric fall patients; and 3) their willingness to conduct fall-prevention interventions.Methods: We conducted an anonymous survey of emergency providers including attending physicians, residents, and physician assistants at a single, urban, Level 1 trauma, tertiary referral hospital in the northeast United States.Results: We had a response rate of 75% (102/136). The majority of providers felt that all geriatric patients should undergo screening for fall risk factors (84%, 86/102), and most (76%, 77/102) answered that all geriatric patients screened and at risk for falls should have an intervention performed. While most (80%, 82/102) answered that geriatric falls prevention was very important, providers were not willing to spend much time on screening or interventions. Less than half (44%, 45/102) were willing to spend 2-5 minutes on a fall risk assessment and prevention, while 46% (47/102) were willing to spend less than 2 minutes.Conclusion: Emergency providers understand the importance of geriatric fall prevention but lack knowledge of which patients to screen and are not willing to spend more than a few minutes on screening for fall interventions. Future studies must take into account provider knowledge and willingness to intervene.

Introduction: Frailty is associated with adverse outcomes among patients attending emergency departments (EDs). While multiple frailty screens are available, little is known about which variables are important to incorporate and how best to facilitate accurate, yet prompt ED screening. To understand the core requirements of frailty screening in ED, we conducted an international, modified, electronic two-round Delphi consensus study.Methods: A two-round electronic Delphi involving 37 participants from 10 countries was undertaken. Statements were generated from a prior systematic review examining frailty screening instruments in ED (logistic, psychometric and clinimetric properties). Reflexive thematic analysis generated a list of 56 statements for Round 1 (August–September 2021). Four main themes identified were: (i) principles of frailty screening, (ii) practicalities and logistics, (iii) frailty domains and (iv) frailty risk factors.Results: In Round 1, 13/56 statements (23%) were accepted. Following feedback, 22 new statements were created and 35 were re-circulated in Round 2 (October 2021). Of these, 19 (54%) were finally accepted. It was agreed that ideal frailty screens should be short (<5 min), multidimensional and well-calibrated across the spectrum of frailty, reflecting baseline status 2–4 weeks before presentation. Screening should ideally be routine, prompt (<4 h after arrival) and completed at first contact in ED. Functional ability, mobility, cognition, medication use and social factors were identified as the most important variables to include.Conclusions: Although a clear consensus was reached on important requirements of frailty screening in ED, and variables to include in an ideal screen, more research is required to operationalise screening in clinical practice.

Objectives: The objectives were to examine whether responses to the Stopping Elderly Accidents, Death, and Injuries (STEADI) questions responses predicted adverse events after an older adult emergency department (ED) fall visits and to identify factors associated with such recurrent fall.Methods: We conducted a prospective study at two urban, teaching hospitals. We included patients aged ≥ 65 years who presented to the ED for an accidental fall. Data were gathered for fall‐relevant comorbidities, high‐risk medications for falls, and the responses to 12 questions from the STEADI guideline recommendation. Our outcomes were the number of 6‐month adverse events that were defined as mortality, ED revisit, subsequent hospitalization, recurrent falls, and a composite outcome.Results: There were 548 (86.3%) patients who completed follow‐up and 243 (44.3%) patients experienced an adverse event after a fall within 6 months. In multivariate analysis, seven questions from the STEADI guideline predicted various outcomes. The question “Had previous fall” predicted recurrent falls (odds ratio [OR] = 2.45, 95% confidence interval [CI] = 1.52 to 3.97), the question “Feels unsteady when walking sometimes” (OR = 2.34, 95% CI = 1.44 to 3.81), and “Lost some feeling in their feet” predicted recurrent falls. In addition to recurrent falls risk, the supplemental questions “Use or have been advised to use a cane or walker,” “Take medication that sometimes makes them feel light‐headed or more tired than usual,” “Take medication to help sleep or improve mood,” and “Have to rush to a toilet” predicted other outcomes.Conclusion: A STEADI score of ≥4 did not predict adverse outcomes although seven individual questions from the STEADI guidelines were associated with increased adverse outcomes within 6 months. These may be organized into three categories (previous falls, physical activity, and high‐risk medications) and may assist emergency physicians to evaluate and refer high‐risk fall patients for a comprehensive falls evaluation.