Background: The Short Physical Performance Battery (SPPB) is widely used to predict negative health-related outcomes in older adults. However, the cutoff point for the detection of the frailty syndrome is not yet conclusive. Objective: The aim of this study was to determine the diagnostic value of the SPPB for detecting frailty in community-dwelling older adults. Design: This was a population-based cross-sectional study focusing on households in urban areas. A total of 744 people who were 65 years old or older participated in this study. Methods: Frailty was determined by the presence of 3 or more of the following components: unintentional weight loss, self-reported fatigue, weakness, low level of physical activity, and slowness. Diagnostic accuracy measures of the SPPB cutoff points were calculated for the identification of frailty (individuals who were frail) and the frailty process (individuals who were considered to be prefrail and frail). Receiver operating characteristic curves were constructed. Odds ratios for frailty and the frailty process and respective CIs were calculated on the basis of the best cutoff points. A bootstrap analysis was conducted to confirm the internal validity of the findings. Results: The best cutoff point for the determination of frailty was ≤ 8 points (sensitivity = 79.7%; specificity = 73.8%; Youden J statistic = 0.53; positive likelihood ratio = 3.05; area under the curve = 0.85). The best cutoff point for the determination of the frailty process was ≤ 10 points (sensitivity = 75.5%; specificity = 52.8%; Youden J statistic = 0.28; positive likelihood ratio = 1.59; area under the curve = 0.76). The adjusted odds of being frail and being in the frailty process were 7.44 (95% CI = 3.90–14.19) and 2.33 (95% CI = 1.65–3.30), respectively. Limitations: External validation using separate data was not performed, and the cross-sectional design does not allow SPPB predictive capacity to be established. Conclusions: The SPPB might be used as a screening tool to detect frailty syndrome in community-dwelling older adults, but the cutoff points should be tested in another sample as a further validation step.

Objective: To compare frailty, sarcopenia and their respective components to determine which is more effective in identifying the risk of disability in basic and instrumental activities of daily living (BADL and IADL, respectively). Methods: A longitudinal study involving 3,637 individuals without disabilities concerning BADL and 3,696 individuals without disabilities regarding IADL at baseline. Frailty was defined using the phenotype. Sarcopenia was determined according to the criteria proposed by the EWGSOP2: low strength (grip strength <27 kg for men and <16 kg for women), low skeletal muscle mass index (<9.36 kg/m2 for men and <6.73 kg/m2 for women) and low physical performance (gait speed ≤0.8 m/s). In addition to the complete constructs, each component was assessed. Poisson mixed models were utilised, with the outcome identified as incident cases of disability over 8 years, adjusted for covariates. Results: Pre-frailty was associated with a 17% and 18% annual increase in the risk of disability for BADL and IADL, respectively. These figures were 27% and 28% for individuals classified as frail. Sarcopenia was not associated with an increased risk of disability. Amongst the components of frailty and sarcopenia, low physical performance, assessed by gait speed ≤0.8 m/s, was the most effective for identifying the risk of disability (12% per year for BADL and 14% per year for IADL). Conclusion: In clinical practice, low physical performance (gait speed ≤0.8 m/s) may be the preferred tool for screening the risk of functional decline in older adults.

INTRODUCTION: Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers. OBJECTIVES: To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults. METHODS: A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression. RESULTS: The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty. CONCLUSION: Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.

Background: Epidemiological studies demonstrate an association between diabetes and low neuromuscular strength (NMS). However, none have grouped participants into nondiabetics (ND), undiagnosed diabetics (UDD), controlled diabetics (CD), and uncontrolled diabetics (UCD) or investigated what glycated hemoglobin levels (HbA1c) are associated with low NMS (dynapenia) by sex. Methods: We analyzed the association between UDD, CD, and UCD and dynapenia, the extent to which the different groupings of these individuals modifies this association and the association between HbA1c levels and NMS, by sex, in a cross-sectional study involving 5,290 participants ≥50 years from the ELSA study. In the first two analyses, logistic regression models were used with dynapenia (grip strength <26 kg in men and <16 kg in women) as outcome and diabetes (ND, UDD, CD, and UCD) as exposure. Next, linear regression was performed with grip strength as the outcome, and the participants were classified based on HbA1c level as exposure. The models were adjusted by sociodemographic, behavioral, and clinical characteristics. Results: Compared to ND, only UCD was associated with dynapenia (men OR = 2.37 95% CI 1.36–4.14; women OR = 1.67 95% CI 1.01–2.79). This association was less clear, particularly in women, when CD and UCD groups were merged. HbA1c ≥6.5% in men and ≥8.0% in women were associated with lower NMS. Conclusions: UCD increases the chance of dynapenia in both sexes. The different groupings based on diabetes status modify the association between UCD and dynapenia. The threshold of HbA1c associated with reduced NMS is lower in men compared to women.