ORCID Profile
0000-0001-6460-782X
Current Organisations
University of Texas at San Antonio
,
Dalhousie University
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Publisher: Wiley
Date: 04-08-2020
DOI: 10.1111/AJAG.12829
Abstract: To examine the predictive validity of the FRAIL scale for mortality, and diagnostic test accuracy (DTA) against the frailty phenotype (FP). Frailty was measured in 846 community‐dwelling adults (mean age 74.3 [SD 6.3] years, 54.8% female) using a modified FRAIL scale and modified FP. Mortality was matched to death records. The FRAIL scale demonstrated significant predictive validity for mortality up to 10 years (Frail adjHR: 2.60, P .001). DTA findings were acceptable for specificity (86.8%) and Youden index (0.50), but not sensitivity (63.6%), or area under the receiver operator curve (auROC) (0.75). DTA estimates were more acceptable when a cut‐point of ≥2 characteristics was used rather than ≥3 in the primary DTA analysis. The FRAIL scale is a valid predictor of mortality. DTA estimates depend on FRAIL scale cut‐point used. This instrument is a potentially useful frailty screening tool.
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/468156
Abstract: Females with Parkinson’s disease (PD) are vulnerable to frailty. PD eventually leads to decreased physical activity, an indicator of frailty. We speculate PD results in frailty through reduced physical activity. Objective . Determine the contribution of physical activity on frailty in PD ( n = 15 , 65 ± 9 years) and non-PD ( n = 15 , 73 ± 14 years) females. Methods . Frailty phenotype (nonfrail refrail/frail) was categorized and 8 hours of physical activity was measured using accelerometer, global positioning system, and self-report. Two-way ANCOVA (age as covariate) was used to compare physical activity between disease and frailty phenotypes. Spearman correlation assessed relationships, and linear regression determined associations with frailty. Results . Nonfrail recorded more physical activity (intensity, counts, self-report) compared with frail. Self-reported physical activity was greater in PD than non-PD. In non-PD, step counts, light physical activity time, sedentary time, and self-reported physical activity were related to frailty ( R = 0.91 ). In PD, only carbidopa-levodopa dose was related to frailty ( r = 0.61 ). Conclusion . Physical activity influences frailty in females without PD. In PD females, disease management may be a better indicator of frailty than physical activity. Further investigation into how PD associated factors contribute to frailty is warranted.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2017
DOI: 10.11124/JBISRIR-2016-003115
Abstract: The overall research objective of this scoping review is to determine the current evidence on frailty in nursing homes. The objectives of the scoping review are to map the following, as reported in international literature: Fraily tools used in studies on nursing home residents. Prevalence of frailty in nursing home residents. Geriatric syndromes (e.g. cognitive impairment, delirium, depression, falls, incontinence, malnutrition and dizziness) associated with frailty in nursing home residents. Other types of adverse outcomes related to frailty reported. Diverse treatment modalities of frailty in nursing home residents. The questions for the scoping review are: What frailty diagnostic tools have been reported in international literature that have been used in studies on nursing home residents? What prevalence rates of frailty in nursing home residents have been reported in the literature? What types of geriatric syndromes have been reported in the literature as being associated with frailty? What other types of adverse outcomes related to frailty have been reported in the literature? What treatment modalities for frailty have been reported in the literature?
Publisher: American Chemical Society (ACS)
Date: 19-07-2016
DOI: 10.1021/JACS.6B05134
Publisher: Elsevier BV
Date: 02-2021
Publisher: American Chemical Society (ACS)
Date: 27-09-2021
Publisher: Wiley
Date: 27-02-2020
DOI: 10.1111/AJAG.12783
Publisher: Public Library of Science (PLoS)
Date: 11-09-2019
Publisher: Oxford University Press (OUP)
Date: 16-09-2020
Abstract: frailty is a dynamic condition for which a range of interventions are available. Health state utilities are values that represent the strength of an in idual’s preference for specific health states, and are used in economic evaluation. This is a topic yet to be examined in detail for frailty. Likewise, little has been reported on minimally important difference (MID), the extent of change in frailty status that in iduals consider to be important. to examine the relationship between frailty status, for both the frailty phenotype (FP) and frailty index (FI), and utility (preference-based health state), and to determine a MID for both frailty measures. population-based cohort of community-dwelling Australians. in total, 874 adults aged ≥65 years (54% female), mean age 74.4 (6.2) years. frailty was measured using the FP and FI. Utilities were calculated using the short-form 6D health survey, with Australian and UK weighting applied. MID was calculated cross-sectionally. for both the FP and FI, frailty was significantly statistically associated (P & 0.001) with lower utility in an adjusted analysis using both Australian and UK weighting. Between-person MID for the FP was identified as 0.59 [standard deviation (SD) 0.31] (anchor-based) and 0.59 (distribution-based), whereas for the FI, MID was 0.11 (SD 0.05) (anchor-based) and 0.07 (distribution-based). frailty is significantly associated with lower preference-based health state utility. Frailty MID can be used to inform design of clinical trials and economic evaluations, as well as providing useful clinical information on frailty differences that patients consider important.
Publisher: Wiley
Date: 04-12-2017
DOI: 10.1111/AJAG.12487
Abstract: To determine the prevalence of frailty and associated factors in the North West Adelaide Health Study (2004-2006) using the Frailty Phenotype (FP) and Frailty Index (FI). Frailty was measured in 909 community-dwelling participants aged ≥65 years using the FP and FI. The FP classified 18% of participants as frail and the FI 48%. The measures were strongly correlated (r = 0.76, P < 0.001) and had a kappa agreement of 0.38 for frailty classification, with 37% of participants classified as non-frail by the FP being classified as frail by the FI. Being older, a current smoker, and having multimorbidity and polypharmacy were associated with higher frailty levels by both tools. Female, low income, obesity and living alone were associated with the FI. Frailty prevalence was higher when assessed using the FI. Socioeconomic factors and other health determinants contribute to higher frailty levels.
Publisher: Oxford University Press (OUP)
Date: 11-08-2022
Abstract: This study investigated the reliability and convergent validity of the PFFS-Malay version (PFFS-M) among patients (with varying educational levels), caregivers, and health care professionals (HCPs). PFFS-M cutoffs for frailty severity were developed. This is a cross-sectional study from 4 primary care clinics where 240 patients aged & years and their caregivers were enrolled. Patients were assigned to a nurse or a health care assistant (HCA) for 2 separate PFFS-M assessments administered by HCPs of the same profession, as well as by a doctor during the first visit (inter-rater reliability). Patients were also administered the Self-Assessed Report of Personal Capacity & Healthy Ageing (SEARCH) tool, a 40-item frailty index, by a research officer. The correlation between patients’ PFFS-M scores and SEARCH tool scores determined convergent validity. Patients returned 1 week later for PFFS-M reassessment by the same HCPs (test–retest reliability). Caregivers completed the PFFS-M for the patient at both clinic visits. Classification cut-points for the PFFS-M were derived against frailty categories defined through the SEARCH tool. The inter-rater (intraclass correlation coefficient [ICC] = 0.92 [95% CI, 0.90–0.93)] and test–retest (ICC = 0.94 [95% CI, 0.92–0.95]) reliability between all raters was excellent, including by patients’ education levels. The convergent validity was moderate (r = 0.637, p & 0.001), including for varying educational background. PFFS-M categories were identified as: 0–3, no frailty 4–5, at risk of frailty 6–8, mild frailty 9–12, moderate frailty and & , severe frailty. PFFS-M is a reliable and valid tool with frailty severity scores now established for use of this tool in primary care clinics.
Publisher: Wiley
Date: 26-10-2016
DOI: 10.1111/JGS.14490
Abstract: To compare the FRAIL-NH scale with the Frailty Index in assessing frailty in residential aged care facilities. Cross-sectional. Six Australian residential aged care facilities. In iduals aged 65 and older (N = 383, mean aged 87.5 ± 6.2, 77.5% female). Frailty was assessed using the 66-item Frailty Index and the FRAIL-NH scale. Other measures examined were dementia diagnosis, level of care, resident satisfaction with care, nurse-reported resident quality of life, neuropsychiatric symptoms, and professional caregiver burden. The FRAIL-NH scale was significantly associated with the Frailty Index (correlation coefficient = 0.81, P < .001). Based on the Frailty Index, 60.8% of participants were categorized as frail and 24.4% as most frail. Based on the FRAIL-NH, 37.5% of participants were classified as frail and 35.9% as most frail. Women were assessed as being frailer than men using both tools (P = .006 for FI P = .03 for FRAIL-NH). Frailty Index levels were higher in participants aged 95 and older (0.39 ± 0.13) than in those aged younger than 85 (0.33 ± 0.13 P = .008) and in participants born outside Australia (0.38 ± 0.13) than in those born in Australia (0.34 ± 0.13 P = .01). Both frailty tools were associated with most characteristics that would indicate higher care needs, with the Frailty Index having stronger associations with all of these measures. The FRAIL-NH scale is a simple and practical method to screen for frailty in residential aged care facilities.
Publisher: Wiley
Date: 05-01-2018
DOI: 10.1111/AJAG.12483
Abstract: To examine frailty prevalence in Australian older adults. Frailty was measured using a modified Fried Frailty Phenotype (FFP) in a combined cohort of 8804 Australian adults aged ≥65 years (female 86%, median age 80 (79-82) years) from the Dynamic Analyses to Optimise Ageing Project and the North West Adelaide Health Study. Using the FFP, 21% of participants were frail while a further 48% were prefrail. Chi-squared testing of frailty among four age groups (65-69, 70-74, 75-79 and 80-84 years) for sex, and marital status revealed that frailty was significantly higher for women (approximately double that of men), increased significantly with advancing age for both sexes, and was significantly higher for women who were widowed, orced or never married. If frailty could be prevented or reversed, it would have an impact on a larger number of older people.
Publisher: Cambridge University Press (CUP)
Date: 15-02-2021
DOI: 10.1017/S1041610220003932
Abstract: To examine the relative contributions of frailty and neuropathology to dementia expression in a population-based cohort study. Cross-sectional analysis of observational data. Population-representative clinicopathological cohort study. Adults aged 75+ recruited from general practice registries in Cambridge, UK, in 1985. A 39-item frailty index and 15-item neuropathological index were used to operationalize frailty and neuropathology, respectively. Dementia status was ascertained by clinical consensus at time of death. Relationships were evaluated using logistic regression models in participants with autopsy records ( n = 183). Model fit was assessed using change in deviance. Population attributable fraction for frailty was evaluated in relation to dementia incidence in a representative s le of the survey participants ( n = 542). Participants with autopsy were 92.3 ± 4.6 years at time of death, and mostly women (70%). Average frailty index value at last survey before death was 0.34 ± 0.16. People with dementia (63% of the s le) were frailer, had lower MMSE scores, and a higher burden of neuropathology. Frailty and neuropathological burden were significantly and independently associated with dementia status, without interaction frailty explained an additional 3% of the variance in the model. Assuming a causal relationship and based on population-attributable fraction analyses, preventing severe frailty (Frailty Index ≥ 0.40) could have avoided 14.2% of dementia cases in this population-based cohort. In the very old, frailty contributes to the risk for dementia beyond its relationship with the burden of traditional dementia neuropathologies. Reducing frailty could have important implications for controlling the burden of dementia. Future research on frailty interventions should include dementia risk as a key outcome, public health interventions and policy decisions should consider frailty as a key risk factor for dementia, and biomedical research should focus on elucidating shared mechanisms of frailty and dementia development.
Publisher: Wiley
Date: 18-07-2019
DOI: 10.1111/JGS.16066
Abstract: Frailty places in iduals at greater risk of adverse health outcomes. However, it is a dynamic condition and may not always lead to decline. Our objective was to determine the relationship between frailty status (at baseline and follow-up) and mortality using both the frailty phenotype (FP) and frailty index (FI). Population-based cohort. Community-dwelling older adults. A total of 909 in iduals aged 65 years or older (55% female), mean age 74.4 (SD 6.2) years, had frailty measurement at baseline. Overall, 549 participants had frailty measurement at two time points. Frailty was measured using the FP and FI, with a mean 4.5 years between baseline and follow-up. Mortality was matched to official death records with a minimum of 10 years of follow-up. For both measures, baseline frailty was a significant predictor of mortality up to 10 years, with initially good predictive ability (area under the curve [AUC] = .8-.9) decreasing over time. Repeated measurement at follow-up resulted in good prediction compared with lower (AUC = .6-.7) discrimination of equivalent baseline frailty status. In a multivariable model, frailty measurement at follow-up was a stronger predictor of mortality compared with baseline. Frailty change for the Continuous FI was a significant predictor of decreased or increased mortality risk based on corresponding improvement or worsening of score (hazard ratio = 1.04 95% confidence interval = 1.02-1.07 P = .001). Frailty measurement is a good predictor of mortality up to 10 years however, recency of frailty measurement is important for improved prediction. A regular review of frailty status is required in older adults. J Am Geriatr Soc 67:2311-2317, 2019.
Publisher: American Chemical Society (ACS)
Date: 08-07-2022
DOI: 10.1021/JACS.2C03376
Abstract: RibB (3,4-dihydroxy-2-butanone 4-phosphate synthase) is a magnesium-dependent enzyme that excises the C4 of d-ribulose-5-phosphate (d-Ru5P) as formate. RibB generates the four-carbon substrate for lumazine synthase that is incorporated into the xylene moiety of lumazine and ultimately the riboflavin isoalloxazine. The reaction was first identified by Bacher and co-workers in the 1990s, and their chemical mechanism hypothesis became canonical despite minimal direct evidence. X-ray crystal structures of RibB typically show two metal ions when solved in the presence of non-native metals and/or liganding non-substrate analogues, and the consensus hypothetical mechanism has incorporated this cofactor set. We have used a variety of biochemical approaches to further characterize the chemistry catalyzed by RibB from
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.EXGER.2019.05.010
Abstract: Detailed information about the current and future geographic distribution of Australia's frail population provides critical evidence to inform policy, resource allocation and planning initiatives that aim to treat and reverse frailty. Frailty is associated with poor health outcomes, including disability and death. It is also characterised by increased health care usage and costs. Understanding the distribution and growth of frailty is important for planning and budgeting service provision and health interventions aimed to support the needs of Australia's growing ageing population. The objective of this research is to provide baseline mapping and area level population estimates of Australia's current and future frail and pre-frail populations. Geospatial modelling was applied to national frailty prevalence rates to provide estimates of the size, distribution and potential growth of Australia's frail and pre-frail population. It is estimated that in 2016 approximately 415,769 people living in Australia aged 65 years or more are frail and almost 1.7 million people are pre-frail. In future years, as the population ages, these figures will increase rapidly, reaching 609,306 frail and 2,248,977 pre-frail by 2027, if prevalence continues at current levels. The geographic distribution of this projected growth is not uniform and while the largest frail populations will continue to be located in the major cities, the fastest growth will be in the outer metropolitan, regional and remote areas. The projected growth of frail populations in outer metropolitan, regional and remote areas may be reduced by targeting health interventions in these areas and improving access to support services. Frailty is a dynamic condition that is amenable to intervention. Reducing frailty will lead to benefits in wellbeing for older Australians in addition to reductions in health care costs.
Publisher: Elsevier BV
Date: 11-2019
Publisher: Wiley
Date: 16-09-2018
DOI: 10.1111/GGI.13522
Abstract: Frailty is a state of decreased physiological reserve and vulnerability to stressors. Understanding the characteristics of those most at risk of worsening, or likely to improve their frailty status, are key elements in addressing this condition. The present study measured frailty state transitions and factors associated with improvement or worsening frailty status in the North West Adelaide Health Study. Frailty was measured using the frailty phenotype (FP) and a 34-item frailty index (FI) for 696 community-dwelling participants aged ≥65 years, with repeated measures at 4.5-year follow up. Improvement in frailty state was common for both tools (FP 15.5% FI 7.9%). The majority remained stable (FP 44.4% FI 52.6%), and many transitioned to a worse level of frailty (FP 40.1% FI 39.5%). For both measures, multimorbidity was associated with worsening frailty among non-frail participants. Among pre-frail participants, normal waist circumference was associated with improvement, whereas older age was associated with worsening of frailty status. Among frail in iduals, younger age was associated with improvement, and male sex and older age were associated with worsening frailty status. Frailty is a dynamic process where improvement is possible. Multimorbidity, obesity, age and sex were associated with frailty transitions for both tools. Geriatr Gerontol Int 2018 18: 1549-1555.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.EXGER.2016.12.021
Abstract: It is a well-described clinical phenomenon that females live longer than males, yet tend to experience greater levels of co-morbidity and disability. Females can therefore be considered both more frail (because they have poorer health status) and less frail (because they have a lower risk of mortality). This systematic review aimed to determine whether this ageing paradox is demonstrated when the Frailty Index (FI) is used to measure frailty. Medline, EMBASE and CINAHL databases were searched for observational studies that measured FI and mortality in community-dwellers over 65years of age. In five-year age groups, meta-analysis determined the sex differences in mean FI (MD=mean FI Of 6482 articles screened, seven articles were included. Meta-analysis of data from five studies (37,426 participants) found that MD values were positive (p<0.001 MD range=0.02-0.06) in all age groups, indicating that females had higher FI scores than males at all ages. This finding was consistent across in idual studies. Heterogeneity was high (I The pattern of sex differences in the FI and mortality of older adults was consistent across populations and confirmed a 'male-female health-survival paradox'.
Publisher: Oxford University Press (OUP)
Date: 10-07-2012
Publisher: Elsevier BV
Date: 12-2016
Publisher: Oxford University Press (OUP)
Date: 08-10-2017
Abstract: Frailty predicts mortality in residential aged care, but the relationship with hospitalization is inconsistent. The purpose of this study was to investigate and compare whether frailty is associated with hospitalization and mortality among residents of aged care services. A prospective cohort study of 383 residents aged 65 years and older was conducted in six Australian residential aged care services. Frailty was assessed using the FRAIL-NH scale and a 66-item frailty index. Overall, 125 residents were hospitalized on 192 occasions and 85 died over the 12-month follow-up. Over this period, less than 3% of the nonfrail/vulnerable residents but more than 20% of the most frail residents died at the facility without hospitalization. Using the FRAIL-NH, residents with mild/moderate frailty had higher numbers of hospitalizations (adjusted incidence rate ratio 1.57, 95% confidence interval [CI] 1.11-2.20) and hospital days (incidence rate ratio 1.48, 95% CI 1.32-1.66) than nonfrail residents. Residents who were most frail had lower numbers of hospitalizations (incidence rate ratio 0.65, 95% CI 0.42-0.99) and hospital days (incidence rate ratio 0.39, 95% CI 0.33-0.46) than nonfrail residents. Similar patterns of associations with number of hospital days were observed for the frailty index. Most frail residents had a higher risk of death than nonfrail residents (for FRAIL-NH, adjusted hazard ratio 2.96, 95% CI 1.50-5.83 for frailty index, hazard ratio 5.28, 95% CI 2.05-13.59). Residents with mild/moderate frailty had higher risk of hospitalization and death than nonfrail residents. Residents who were most frail had higher risk of death but lower risk of hospitalization than nonfrail residents.
Publisher: AMPCo
Date: 09-08-2020
DOI: 10.5694/MJA2.50720
Publisher: Springer Science and Business Media LLC
Date: 03-02-2021
DOI: 10.1186/S12877-020-01974-1
Abstract: The Frailty In Residential Sector over Time (FIRST) Study is a 3-year prospective cohort study investigating the health of residents living in residential aged care services (RACS) in South Australia. The study aims to examine the change in frailty status and associated health outcomes. This interim report presents data from March 2019–October 2020. The study setting is 12 RACS from one organisation across metropolitan and rural South Australia involving 1243 residents. All permanent (i.e. respite or transition care program excluded) residents living in the RACS for at least 8 weeks were invited to participate. Residents who were deemed to be medically unstable (e.g. experiencing delirium), have less than 3 months to live, or not fluent in English were excluded. Data collected included frailty status, medical diagnoses, medicines, pain, nutrition, sarcopenia, falls, dementia, anxiety and depression, sleep quality, quality of life, satisfaction with care, activities of daily living, and life space use at baseline and 12-months. Data Linkage will occur over the 3 years from baseline. A total of 561 permanent residents (mean age 87.69 ± 7.25) were included. The majority of residents were female ( n = 411, 73.3%) with 95.3% ( n = 527) being classified as either frail ( n = 377, 68.2%) or most-frail ( n = 150, 27.1%) according to the Frailty Index (FI). Most residents were severely impaired in their basic activities of daily living ( n = 554, 98.8%), and were at-risk of malnutrition ( n = 305, 55.0%) and at-risk of sarcopenia ( n = 492, 89.5%). Most residents did not experience pain ( n = 475, 85.4%), had normal daytime sleepiness ( n = 385, 69.7%), and low anxiety and depression scores ( n = 327, 58.9%). This study provides valuable information on the health and frailty levels of residents living in RACS in South Australia. The results will assist in developing interventions that can help to improve the health and wellbeing of residents in aged care services. Prospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12619000500156 ).
Publisher: Springer Science and Business Media LLC
Date: 10-06-2017
Publisher: Elsevier BV
Date: 03-2019
Publisher: Springer Science and Business Media LLC
Date: 17-11-2018
Publisher: Springer Science and Business Media LLC
Date: 22-11-2018
DOI: 10.1007/S12603-018-1139-9
Abstract: Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR). To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia (ii) screening and diagnosis (iii) physical activity prescription (iv) protein supplementation (v) vitamin D supplementation (vi) anabolic hormone prescription (vii) medications under development and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefit-harm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process. We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.
Location: United States of America
Location: United States of America
Location: United States of America
No related grants have been discovered for Olga Theou.