Güner Oytun M, et al. J Clin Neurol. 2023 Jan;19:e9. https://doi.org/10.3988/jcn.2022.0219

Introduction: Physical phenotype and the cumulative deficit model are two well-known concepts of frailty. One of the main components of frailty is loss of muscle mass and function, which may also include swallowing muscles, therefore is a risk factor for dysphagia. Since dysphagia is seen starting from the early stages of Alzheimer’s Disease (AD), in this study we aimed to reveal the relationship between frailty and dysphagia and dysphagia-related quality of life through Swallow Quality of Life (SwalQoL) tool in patients with AD and compare them with cognitively intact older adults. Methods: Comprehensive geriatric assessment, dysphagia evaluation by Eating-Assessment Tool (EAT-10) and SwalQoL questionnaire, and frailty assessment via FRAIL and Clinical Frailty Scale (CFS) were performed on all 101 participants of the study. Thirty-five patients were cognitively intact, 36 patients were diagnosed with mild AD, and 30 patients were diagnosed with moderate AD. Results: Sex distribution was similar between the groups, however, there was a statistically significant age difference. The prevalence of frailty increased according to both frailty indexes as the cognitive status deteriorated. All parameters of SwalQoL except fear and sleep parameters deteriorated as cognitive status impaired. In quantile regression of the total score of the SwalQoL questionnaire and multivariable logistic regression of EAT-10, frailty, as defined by CFS and FRAIL, was associated with dysphagia and poor quality of life regardless of age, presence of dementia, as well as nutritional status. Conclusion: Swallowing difficulties in AD negatively affects the quality of life, and it is closely related to frailty in mild-to-moderate AD.

Type 2 diabetes mellitus (T2DM) is a common chronic disease in the elderly. Comorbidities, especially neuropathy and retinopathy, significantly increase fall risk in this group. This study aimed to identify fall risk factors in older adults with T2DM. From January to June 2024, 242 T2DM patients aged 65 and older were followed at the internal medicine outpatient clinic. Fall risk was assessed using the Performance Oriented Mobility Assessment (POMA), Hendrich II Fall Risk Model (HIIFRM), Barthel Activities of Daily Living Index, and Clinical Frailty Scale (CFS). Among the patients (median age = 70 years), 41.3% had experienced at least one fall in the previous year. Factors, such as age and diabetes duration were associated with falls. Notably, hypoglycemia (aPR: 1.90, p = 0.017), polypharmacy (aPR: 2.39, p = 0.004), osteoarthritis (aPR: 2.48, p = 0.017), (aPR: 1.70, p = 0.025), and malnutrition (aPR: 1.90, p = 0.007) were independently associated with fall risk. Fall risk in elderly outpatients with T2DM was linked to various factors, including hospitalization, malnutrition, osteoarthritis, polypharmacy, neuropathy, and hypoglycemia. To mitigate this risk, patient-specific care plans are recommended.