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位置:
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ICFR2011
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Prof. John Morley
PowerPoint Presentation
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標題
1.
Slide 1
2.
Conflicts of Interest
3.
Slide 1
4.
FrailtyObjectives
5.
Conflicts of Interest
6.
Sarcopenia Kratopenia (Thinamopenia)DynapeniaFrailtyDisability
7.
FrailtyObjectives
8.
ADL’s and Outcome
9.
FRAILTY DEFINITIONS
10.
Stressful Social Events increase Mortality in oldest-old males in Hong Kong
11.
Outcomes in Nonagerians after Earthquake in Wenchuan, May 12 2008
12.
Slide 9
13.
FRAILTY DEFINITION OBJECTIVEFried et al J Gerontol 56A M146,2001
14.
Frailty predicts 10 year disability and mortality in Mexican AmericansJ Rehab Med 2001;41:892; Gerontol 2009; 55:64
15.
FRAILTYFatigueResistance (Climb 1 flight stairs)Aerobic (Walk one block)IllnessesLoss of weight
16.
Slide 13
17.
The African American Health Project
18.
Income below $20,000
19.
Slide 16
20.
BMI
21.
Outcome Measures According to Baseline Frail Status(All significant except for Gait Speed)
22.
Mortality at 9 years
23.
Being frail or prefrail also predicted ADLs at 9 years in those without ADL disability at baseline
24.
FRAILTY
25.
Rockwood Deficit Scale10 year outcomesDeficits added >0.25 = Frail
26.
Prevalence of Frailty by Different Scales
27.
Prevalence of Frailty Excluding baseline ADL deficits
28.
Slide 25
29.
Slide 26
30.
Slide 27
31.
Slide 28
32.
CYTOKINES AND FRAILTY
33.
Cytokines and Fraity in AAH Study : sTNFR1
34.
sTNFR1 and Leptin at baseline predict frailty at 9 years
35.
Frailty and Chronic Kidney Disease: The Third National Health and Nutrition Evaluation Survey(July 2009)
36.
Cystatin C at baseline predicts Frailty at 9 years
37.
Hong Kong Study4000 participants ; 4 year follow upWoo et al
38.
HUBBARD (CANADIAN ) Frailty Score
39.
Specificity of Scales in Hong Kong Study
40.
? PsycoSocial Frailty ?
41.
Environment Modulates Longevity
42.
After the fall of the Berlin Wall East Germans rapidly developed a survival equivalent to West Germans
43.
Frailty Cascade
44.
Slide 41
45.
Slide 42
46.
SOCIALCross-Sectional Results
47.
SOCIALLongitudinal Outcomes at 9 years
48.
Slide 45
49.
Effects of Exercise in the FrailTheo et al, J Aging Res 2011
50.
Effects of High-Intensity Progressive Resistance Training and Targeted Multidisciplinary Treatment of Frailty on Mortality and Nursing Home Admissions after Hip Fracture: A Randomized Controlled TrialSingh et al JAMDA , Jan 2012
51.
Treatment for FRAILTY is RESISTANCE EXERCISE
52.
Bed Rest
53.
Testosterone in FrailSrinivas-Shankar, Endo Soc 2008
54.
Testosterone and Heart FailureCaminiti et al, JACC 54:919;2009
55.
Risk of non-elective hospital admission
56.
Slide 53
57.
SARMS
58.
GTx SARM (Ostarine)n=120, Mean age 64.8 yrs
59.
Activin Receptors
60.
Slide 57
61.
frailty
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