Frailty and Functional Status improvement after Skilled Nursing Facility based Post-Acute Care

Abstract People admitted to a skilled nursing facility (SNF) for post-acute care undergo comprehensive evaluation and rehabilitation, potentially enabling prediction of future functional recovery. We identified the first SNF admission per beneficiary (n=250,159) between 07/01/2014 – 06/30/2016 in a 5% Medicare sample, using the Minimum Data Set (MDS) and the Outcome and Assessment Information Set (OASIS). Episodes were excluded for non-community discharge (n=43,397) or no OASIS admission assessment within 14 days of SNF discharge (n=77,989). A deficit accumulation Frailty Index (FI) was measured on admission MDS assessment and categorized into robust (MDS-FI<0.15), pre-frailty (MDS-FI0.15-0.24), mild frailty (MDS-FI0.25-0.34), and moderate or worse frailty (MDS-FI≥0.35). Outcomes were functional decline obtained from OASIS, readmission, or death after initiation of home care. Functional status was measured by activities of daily living from OASIS assessments. A total of 135,310 SNF episodes were matched to OASIS episodes. Of these, there were 6,472 (4.8%) robust patients, 38,923 (28.8%) pre-frail, 63,727 (47.1%) mildly frail and 26,053 (19.3%) moderately frail or worse. In a logistic regression after adjustment for OASIS admission function, compared to robust status, frailty was associated with hospital readmission or death within 30 days of OASIS admission, (mild frailty OR1.33 [95%CI 1.23-1.45] and moderate or worse OR1.81 [95%CI 1.66-1.97]). Frailty was also associated with functional decline at OASIS discharge, after adjustment for OASIS admission function (mild frailty OR1.50 [95%CI 1.38-1.63] and moderate or worse OR2.30 [95%CI 2.11-2.50]). Among those discharged from SNF with home services, a SNF-based MDS-FI is associated with increased likelihood of poor community outcomes.


FRAILTY AND MACRONUTRIENTS INTAKE AMONG OLDER BRAZILIAN ADULTS
Carolina Freiria, 1 Graziele Silva, 2 Larissa Hara, 2 Tábatta Brito, 3 Flávia Arbex Silva Borim, 1 and Ligiana Corona, 2 1.University of Campinas,Campinas,Sao Paulo,Brazil,2.University of Campinas, University of Campinas,Sao Paulo,Brazil,3. Federal University of Alfenas,Federal University of Alfenas,Sao Paulo,Brazil The adequate nutrition has an important role in the prevent and treatment of frailty, however, there are only few studies showing the relationship between macronutrients intake and this geriatric syndrome, especially in Latin countries.The aim of this study was to analyze the association between macronutrients intake and frailty among older adults in Brazil.This study included 521 community-dwelling individuals aged 60 years old or older.Frailty was assessed using a self-reported instrument and individuals were categorized in two groups: frail and non-frail (robust + pre frail).Food consumption was evaluated using the 24-hour recall and the software NDSR®.Differences between groups was assessed using the Mann Whitney test.The prevalence of frailty was 42.0%.Older adults considered frails presented lower intake of calories (1510.9kcal vs 1639.3 kcal; p = 0.016), carbohydrates (196.8 g vs 213.3 g; p = 0.011), proteins (60.7 g vs 68.5 g; p = 0.016) and fiber (15.1 g vs 17.5 g; p= 0.002).They also had lower intake of protein per kilograms of weight (0.88 g/kg vs 0.99 g/kg; p= 0.010).The findings demonstrate high prevalence of frail in our sample, and that intake of most macronutrients was significantly lower among older adults with frail, indicating the importance of the screening of frail as well the evaluation of macronutrients intake among community-based older adults, to prevent malnutrition, sarcopenia and frailty in this population.

hey also had lower intake of protein per kilograms of weight (0
88 g/kg vs 0.99 g/kg; p= 0.010).The findings demonstrate high prevalence of frail in our sample, and that intake of most macronutrients was significantly lower among older adults with frail, indicating the importance of the screening of frail as well the evaluation of macronutrients intake among community-based older adults, to prevent malnutrition, sarcopenia and frailty in this population.


FRAILTY IN A FRAILTY PREVENTION PROGRAM PARTICIPANTS DURING COVID-19 PANDEMIC:

A CROSS-SECTIONAL JAPANESE STUDY Takuya Kanamori, 1 Mizue Suzuki, 1 Tomoyoshi Naito, 1 Keigo Inagaki, 1 and Hiroyuki Umegaki, 2 1. Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan, 2. Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

Objective: Health conditions of older adults have deteriorated during the COVID-19 pandemic.Few studies have reported on the frailty of this group of people.The study aimed to investigate physical and social frailty in participants in a frailty prevention program during the COVID-19 pandemic.Methods: A cross-sectional survey was conducted in Japan from January 2021.Further, 863 participants of a frailty prevention program completed the survey.The frequency of program attendance in 2020, physical frailty (5-item frailty screening index), social frailty(diagnostic criteria of social frailty in NCGG-SGS), and depression (GDS-5) were assessed.A related factor of physical frailty was analyzed statistically by Welch's t test and the Chi-squared test.Results: The study participants' mean age, proportion of women, and mean enrollment period in program were 86.8±4.9, 96.3%, 64.3±48.6 months, respectively.The program attendance ratio was 83.4% from January to March, 54.5% from April to June, 79.8% from July to September, and 80.0% from October to December.The prevalence of physical frailty was 20.3% non-frailty, 63.7% pre-frailty, and 15.6% frailty.The prevalence of social frailty was 10.0% non-frailty, 28.6% social pre-frailty, 61.8% social frailty, and the prevalence of depression was 36.8%.Participants with physical frailty were significantly older and showed higher prevalence of social frailty and depression, displaying significantly lower attendance program than non-frailty and pre-frailty older adults (p<0.05).Conclusions: The study results suggest that more than half of the participants of a frailty prevention program have social frailty and a high risk of physical frailty due to COVID-19.


FRAILTY PREVALENCE AND ASSOCIATION WITH MORTALITY ACROSS BIRTH COHORTS IN SWEDISH REGISTRY DATA

Alexandra Wennberg, and Karin Modig, Karolinska Institutet, Stockholm, Stockholms Lan, Sweden Frailty is associated with poor health outcomes, reduced quality of life, and mortality.To understand how prevalence of frailty may have changed across birth cohorts, we investigated frailty prevalence at ages 75, 85, and 95 in people
 Innovation inAging, 2021, Vol. 5, No. S1

FRAILTY IN A FRAILTY PREVENTION PROGRAM PARTICIPANTS DURING COVID-19 PANDEMIC:
A CROSS-SECTIONAL JAPANESE STUDY Takuya Kanamori, 1 Mizue Suzuki, 1 Tomoyoshi Naito, 1 Keigo Inagaki, 1 and Hiroyuki Umegaki, 2 1. Hamamatsu University School of Medicine, Hamamatsu city, Shizuoka, Japan, 2. Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan Objective: Health conditions of older adults have deteriorated during the COVID-19 pandemic.Few studies have reported on the frailty of this group of people.The study aimed to investigate physical and social frailty in participants in a frailty prevention program during the COVID-19 pandemic.Methods: A cross-sectional survey was conducted in Japan from January 2021.Further, 863 participants of a frailty prevention program completed the survey.The frequency of program attendance in 2020, physical frailty (5-item frailty screening index), social frailty(diagnostic criteria of social frailty in NCGG-SGS), and depression (GDS-5) were assessed.A related factor of physical frailty was analyzed statistically by Welch's t test and the Chi-squared test.Results: The study participants' mean age, proportion of women, and mean enrollment period in program were 86.8±4.9, 96.3%, 64.3±48.6 months, respectively.The program attendance ratio was 83.4% from January to March, 54.5% from April to June, 79.8% from July to September, and 80.0% from October to December.The prevalence of physical frailty was 20.3% non-frailty, 63.7% pre-frailty, and 15.6% frailty.The prevalence of social frailty was 10.0% non-frailty, 28.6% social pre-frailty, 61.8% social frailty, and the prevalence of depression was 36.8%.Participants with physical frailty were significantly older and showed higher prevalence of social frailty and depression, displaying significantly lower attendance program than non-frailty and pre-frailty older adults (p<0.05).Conclusions: The study results suggest that more than half of the participants of a frailty prevention program have social frailty and a high risk of physical frailty due to COVID-19.

FRAILTY PREVALENCE AND ASSOCIATION WITH MORTALITY ACROSS BIRTH COHORTS IN SWEDISH REGISTRY DATA
Alexandra Wennberg, and Karin Modig, Karolinska Institutet, Stockholm, Stockholms Lan, Sweden Frailty is associated with poor health outcomes, reduced quality of life, and mortality.To understand how prevalence of frailty may have changed across birth cohorts, we investigated frailty prevalence at ages 75, 85, and 95 in people


