Laksmi PW1, Ainun N2, Setyohadi B3, Setiati S2, Ariane A3, Tirtarahardja G4

1Geriatric
Division, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital; 2Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto
Mangunkusumo Hospital; 3Rheumatology Division, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital; 4Osteoporosis Centre-Medistra Hospital,

Table 1. Clinical Features of Study Subjects Results

Introduction
Variables Male Female Total
(n = 46) (n = 74) N = 120 The proportion of frail, pre-frail and robust subjects were
Frailty syndrome is described as a state of diminishing
physiological reserves caused by accumulation of BMI (kg/m2)* 21.85 (3.81) 22.88 (5.00) 22.48 (4.59) 29.17%, 58.33%, and 12.5% respectively. There was a
multidimensional deficits due to aging. Frailty syndrome is BMI category, n (%)
significant difference in ALM/ht2 between frail and non-frail
inversely related with the quality of life of elderly patients. Underweight (<18.5 kg/m2) 10 (21.7) 15 (20.3) 25 (20.8) subjects [6.54 (1.01) vs. 7.03 (0.91) kg/m2; p = 0.01], but
Normoweight (18.5–22.9 kg/m2) 20 (43.5) 25 (33.8) 45 (37.5)
A theoretical link between frailty and low lean mass has Overweight (23–24.9 kg/m2) 6 (13) 6 (8.1) 12 (10)
nonsignificant result for ALM/BMI. No significant
been established, however previous studies have shown Obese (≥25 kg/m2) 10 (21.7) 28 (37.8) 38 (31.7) association was found between frailty and muscle mass
inconclusive results. Muscle Mass Index
index. Based on multivariate analysis, frailty was
ALM/ht2 (kg/m2)* 7.49 (0.91) 6.53 (0.82) 6.88 (0.96) significantly associated with nutritional status (OR 3.67;
ALM/BMI (kg/kg/m2)+ 0.93 (0.65–1.20) 0.70 (0.55–1.11) 0.77 (0.55–1.20)
95%CI 1.59–8.49) and functional status (OR 4.94; 95%CI
Fat Mass (kg)+ 11.97 (1.80–28.13) 15.93 (1.23–43.04) 13.36 (1.23–43.04) 2.01–11.75).
Lean Mass (kg)* 44.32 (7.25) 37.41 (5.59) 40.06 (7.09)
Objectives Table 3. Association between Muscle Mass and Frailty Syndrome
Nutritional Status (MNA), n (%)
To investigate the association between muscle mass index Malnourished 0 (0.0) 2 (2.7) 2 (1.66) ALM/ht2 ALM/BMI
At risk of malnourished 13 (28.3) 25 (33.8) 38 (31.67) PR 95%CI p PR 95%CI p
and physical frailty in elderly outpatients.. Normal 33 (71.7) 47 (63.5) 80 (66.67)
Frailty Syndrome 2.03 0.80–5.15 0.13† 5.09 0.45–58 0.2‡
Functional Status+ 20 (15–20)
Mildly dependent ), n (%)* 8 (17.4) 25 (33.8) 33 (27.5) Table 4. Bivariate Analysis of Confounding Factors
Independent, n (%)* 38 (82.6) 49 (66.2) 87 (72.5)
Frailty
Method Confounding Factors
OR 95%CI p
CIRS score+ 6 (1–16)
Age 1.22 0.50–2.95 0.66†
>5, n (%)* 26 (56.5) 47 (63.5) 73 (60.83)
Gender 1.53 0.66–3.52 0.32†
A cross-sectional study was conducted on elderly (≥60 ≤5, n (%)* 20 (43.5) 27 (36.5) 47 (39.17)
Comorbid 1.93 0.82–1.51 0.13‡
years old) at Geriatric Clinic, Cipto Mangunkusumo Hospital Walking time (second)+ 5.84 (3.20–12.13) 5.91 (3.37–16.60) 5.91 (3.20–16.60)
Nutritional Status 3.67 1.59–8.49 0.02†
Functional status 4.94 2.01–11.75 0.00‡
during April-June 2018. Each subject underwent Handgrip strength (kg)+ 26.50 (10–40) 18.00 (10–35) 20.00 (10–40)
anthropometric measurement, frailty evaluation using
Cardiovascular Health Study (CHS) questionnaire, and lean Table 2. Muscle Mass Index Based on Frailty Status
Conclusion
mass measurement using dual energy X-ray absorptiometry
Frail Not frail p
(DXA). Appendicular lean mass (ALM) measurement was (n = 35) (n = 85) Muscle mass index was not significantly associated with
adjusted by height squared (ALM/ht2) and body mass index ALM/ht2 (kg/m2), mean (SD) 6.54 (1.01) 7.03 (0.91) 0.01† physical frailty, but nutritional and functional status were.
(ALM/BMI) to indicate muscle mass index.
ALM/BMI (kg/kg/m2), median (min–max) 0.77 (0.55–1.18) 0.78 (0.55–1.20) 0.72††