Objectives To compare the ability of Frailty Phenotype (FP), FRAIL and Frailty Index (FI) to predict adverse outcomes. Design A prospective cohort study. Setting A senior community in Beijing, China. Participants A total of 188 older adults aged 65 years or older (mean age 84.0 ± 4.4 years, 58.5% female). Measurements Frailty was evaluated by FP, FRAIL and FI. The agreement between scales was assessed by Cohen kappa coefficient. The predictive value of the three scales for adverse outcomes during one-year follow-up period were analyzed using decision curve analysis(DCA) and receiver operating characteristic curve (ROC) analysis. Results Frailty ranged from 25% (FRAIL) to 42.6% (FI). The agreement between scales was moderate to good (Cohen’s kappa coefficient 0.44∼0.61). DCA showed though the curves of the scales overlapped across all relevant risk thresholds, clinical treating had a higher net benefit than “treat all” and “treat none” when risk of unplanned hospital visits ≥30%, risk of functional decline or falls ≥15%. The three scales had similar predictive value for unplanned hospital visits (area under ROC, AUC 0.63, 0.64 and 0.69). FRAIL and FI had similar predictive value for functional decline (AUC 0.63,0.65). FI had predictive value for falls (AUC 0.65). Conclusions All three scales showed clinical utility but FRAIL may be best in practice because it is simple. Multidimensional measures of frailty are better than unidimensional for prediction of adverse outcomes among older adults.

The occurrence of gastroesophageal reflux disease (GERD) and symptom onset are closely associated with diet. We aimed to compare the dietary and lifestyle triggers between non-erosive reflux disease (NERD) and reflux esophagitis (RE) in Chinese patients and to provide evidence for development of practical dietary modifications for GERD. A multicenter cross-sectional survey was conducted. A total of 396 GERD patients with typical gastroesophageal reflux symptoms who received upper endoscopy in the previous month were enrolled, including 203 cases of NERD patients and 193 cases of RE patients. All participants completed questionnaires including demographic data, reflux symptoms, previous management, dietary and lifestyle habits, triggers of reflux symptoms, psychological status, and quality of life. There were no significant differences in GERD symptom scores between NERD and RE. RE patients had a higher male proportion and smoking/drinking and overeating rates than NERD patients. In the NERD group, more patients reported that fruits, dairy products, yogurt, bean products, cold food, and carbonated beverages sometimes and often induced reflux symptoms and had more triggers compared to RE patients. The number of triggers was positively correlated to GERD symptom score and GERD-HRQL score in both NERD and RE patients. However, 74.0% of GERD patients still often consumed the triggering foods, even those foods that sometimes and often induced their reflux symptoms, which might be related to the reflux relapse after PPI withdrawal considering NERD and RE patients had similar GERD symptom severity. There were some differences in terms of dietary habits, dietary and lifestyle triggers, and related quality of life between NERD and RE, and these results may provide evidence of different approaches toward the dietary modification of NERD and RE patients.

Background: With global aging, diet education and oral nutritional supplements (ONS) are recognized for improving nutrition and appetite in older adults, yet evidence on anorexia of aging (AA) mechanisms and interventions remains limited in China. This study aimed to evaluate diet education and ONS efficacy for AA in Chinese community-dwelling older adults.Methods: In an open-label, non-randomized controlled trial, 64 eligible participants were allocated to an ONS group (supplementation) or a diet education group. The Simplified Nutritional Appetite Questionnaire (SNAQ) assessed AA, with follow-ups at weeks 2, 4, 8, and 12. Primary outcomes were SNAQ improvements; secondary outcomes included weight, grip strength, nutritional status (BMI, MNA-SF), cognition (MMSE), mobility (SPPB), mental health (GDS15), and quality of life (EQ-5D).Results: Younger, non-solo-living, and malnourished participants preferred ONS intervention (p < 0.05). Both groups showed increased SNAQ scores versus baseline (counseling: weeks 4/8/12; ONS: weeks 2/4/8/12), with ONS achieving significantly greater improvement at week 2 (p < 0.05). Weight remained unchanged in both groups (p > 0.05). Diet education increased grip strength at week 12 (p < 0.05), while no significant improvements occurred in BMI, cognition, mobility, or quality of life.Conclusion: Both ONS and diet education alleviated AA over 12 weeks, but ONS demonstrated earlier efficacy (significant SNAQ improvement by week 2). However, ONS did not enhance weight, physical function, or cognitive outcomes.Trial registration: Approved by Peking Union Medical College Hospital Ethics Committee (I-23PJ661), registered at Chinese Clinical Trial Registry (MR-11-23-023104).