Weakness: The most frequent criterion among pre-frail and frail older Portuguese.

AIM: In Portugal, the burden of pre-frailty and frailty in community-dwelling older adults is still unknown. The purpose of this study is to estimate the frequency of frailty in a Portuguese sample with ≥ 65years and to evaluate its associated factors. We also intend to identify which criterion has more impact on the diagnosis of frailty. METHODS: 1457 older adults with ≥ 65years from the Nutrition UP 65 study were evaluated in a cross-sectional analysis. Frailty was identified according to Fried et al. by the presence of three or more of the following factors: unintentional weight loss, self-reported exhaustion, slowness, weakness and low physical activity. Pre-frailty was defined as the presence of one or two of these criteria. The association between individuals' characteristics and frailty status was analysed through logistic regression analysis. RESULTS: The frequency of pre-frailty and frailty is 54.3% and 21.5%, respectively. In older adults classified as pre-frail or frail, 76.7% presented weakness and 48.6% exhaustion. In multivariate analyses, frailty was associated with age >75, lower education level, being single, divorced or widower, being professionally inactive, poor self-perception of health status, not drinking alcohol, being obese and undernourished or at undernutrition risk. CONCLUSION: This condition is very prevalent in Portuguese older adults, one fifth are frail whereas half are pre-frail. Weakness identified by low handgrip strength is the most prevalent criterion in pre-frail and frail Portuguese older adults.

Differences in handgrip strength protocols to identify sarcopenia and frailty - a systematic review.

BACKGROUND: Hand grip strength (HGS) is used for the diagnosis of sarcopenia and frailty. Several factors have been shown to influence HGS values during measurement. Therefore, variations in the protocols used to assess HGS, as part of the diagnosis of sarcopenia and frailty, may lead to the identification of different individuals with low HGS, introducing bias. The aim of this systematic review is to gather all the relevant studies that measured HGS to diagnose sarcopenia and frailty and to identify the differences between the protocols used. METHODS: A systematic review was carried out following the recommendations of The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed and Web of Science were systematically searched, until August 16, 2016. The evidence regarding HGS measurement protocols used to diagnose sarcopenia and frailty was summarised and the most recent protocols regarding the procedure were compared. RESULTS: From the described search 4393 articles were identified. Seventy-two studies were included in this systematic review, in which 37 referred to sarcopenia articles, 33 to frailty and two evaluated both conditions. Most studies presented limited information regarding the protocols used. CONCLUSIONS: The majority of the studies included did not describe a complete procedure of HGS measurement. The high heterogeneity between the protocols used, in sarcopenia and frailty studies, create an enormous difficulty in drawing comparative conclusions among them.