Key result
Only the 32-item Frailty Index identifies larger standing blood pressure deficits versus non-frail adults.
Why the study?
Do different frailty identification criteria capture distinct neurocardiovascular responses during an active stand test in older adults?
Observational (n=1,124)
Do different frailty identification criteria capture distinct neurocardiovascular responses during an active stand test in older adults?
The 32-item Frailty Index is more adept than the physical Frailty Phenotype or Clinical Frailty Scale at capturing distinct neurocardiovascular responses to standing, such as orthostatic hypotension, in older adults.
FI may better detect orthostatic responses than other frailty tools; leaves open optimal screening choice in older adults.
In this observational study, we compared continuous physiological signals during an active stand test in adults aged 50 years and over, characterized as frail by three different criteria, using data from The Irish Longitudinal Study on Ageing (TILDA). Four independent groups were identified: those characterized as frail only by one of the frailty tools used (the physical Frailty Phenotype (FP), the 32-item Frailty Index (FI), or the Clinical Frailty Scale (CFS) classification tree), and a fourth group where participants were not characterized as frail by any of these tools. Continuous non-invasive physiological signals were collected during an active stand test: systolic (sBP) and diastolic (dBP) blood pressure, as well as heart rate (HR), using digital artery photoplethysmography. Additionally, frontal lobe cerebral oxygenation (Oxy), deoxygenation (Deoxy), and tissue saturation index (TSI) were also non-invasively measured using near-infrared spectroscopy (NIRS). The signals were visualized across frailty groups and statistically compared using one-dimensional statistical parametric mapping (SPM). A total of 1,124 participants (mean age 63.5 years, 50.2% women) were included: 23 were characterized as frail only by FP, 97 by FI, 38 by CFS, and 966 by none of these criteria. SPM analyses revealed that only the group characterized as frail by FI had significantly different signals (p<0.05) compared to the non-frail group. Specifically, they exhibited a lesser increase in HR between 5-15 seconds post-stand and larger deficits in sBP and dBP between 15-40 seconds post-stand, and possibly a lower Delta TSI at 20 seconds post-stand. In this comparison, the FI proved more adept at capturing distinct physiological responses to standing, likely due to its direct inclusion of cardiovascular morbidities in its definition.
No takes yet. Share an insight, caveat, or question.
Feng et al. (2023) conducted an observational in Frailty (n=1,124). Frailty identification criteria (FP, FI, CFS) vs. Non-frail was evaluated on Continuous non-invasive physiological signals during an active stand test (p=<0.05). Only the 32-item Frailty Index identified significantly different physiological responses to standing, including larger blood pressure deficits, compared to non-frail adults (p<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: