{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:51:31Z","timestamp":1780548691240,"version":"3.54.1"},"reference-count":61,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Point-of-care lung ultrasonography (LUS) represents an accurate diagnostic tool in older patients with respiratory failure. The integration of LUS with ultrasonographic assessment of diaphragm thickness and excursion, right vastus lateralis (RVL) muscle thickness and cross-sectional area (CSA) could provide real-time information on frailty and sarcopenia. The primary aim of this proof-of-concept prospective study was to evaluate clinical correlates of thoracic, diaphragmatic, and muscular ultrasound to characterize the associations between frailty, respiratory failure, and sarcopenia in older patients hospitalized for acute respiratory complaints. Methods: Each of 52 participants (age median 84, IQR 80\u201389 years old) underwent integrated LUS, diaphragm and RVL ultrasound examination upon admission (T0) and after 72 h of hospitalization (T1). LUS score was used to estimate lung interstitial syndrome severity. Diaphragm excursion, thickness, RVL thickness and CSA were measured following a standardized protocol. Frailty was assessed with the PC-FI (Primary Care-Frailty Index). Results: All patients exhibited multifactorial causes of respiratory symptoms. The LUS score on T0 predicted 3-month rehospitalization. Frail patients exhibited higher LUS scores on T1. Diaphragm excursion on T0 was reduced in patients with COPD and heart failure and in those developing delirium during hospitalization. Diaphragm excursion on T1 was negatively associated with PC-FI. Diaphragm thickness, RVL thickness, and CSA exhibited a positive association with obesity. Right vastus lateralis CSA on T1, however, was also negatively associated with PC-FI. Conclusions: Integrated lung, diaphragm, and RVL ultrasound shows clinical correlations with several aspects of frailty that may help to improve the management of geriatric patients with respiratory illness.<\/jats:p>","DOI":"10.3390\/diagnostics15010087","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T10:32:26Z","timestamp":1735813946000},"page":"87","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Integrated Lung, Diaphragm and Lower Limb Muscular Ultrasound: Clinical Correlations in Geriatric Patients with Acute Respiratory Illness"],"prefix":"10.3390","volume":"15","author":[{"given":"Nicoletta","family":"Cerundolo","sequence":"first","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"},{"name":"GRETA Research Group on Thoracic Ultrasound in the Elderly, Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-1074","authenticated-orcid":false,"given":"Carmine","family":"Siniscalchi","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-7393","authenticated-orcid":false,"given":"Chukwuma","family":"Okoye","sequence":"additional","affiliation":[{"name":"GRETA Research Group on Thoracic Ultrasound in the Elderly, Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy"},{"name":"School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy"},{"name":"Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori Hospital, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-2708","authenticated-orcid":false,"given":"Simone","family":"Scarlata","sequence":"additional","affiliation":[{"name":"GRETA Research Group on Thoracic Ultrasound in the Elderly, Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy"},{"name":"Unit of Internal Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy"},{"name":"Research Unit of Internal Medicine, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Parise","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Rendo","sequence":"additional","affiliation":[{"name":"Primary Care Department, Parma District, Azienda Unit\u00e0 Sanitaria Locale di Parma, 43125 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Guerra","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Meschi","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2680-2242","authenticated-orcid":false,"given":"Antonio","family":"Nouvenne","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"},{"name":"GRETA Research Group on Thoracic Ultrasound in the Elderly, Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy"},{"name":"Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9171-8592","authenticated-orcid":false,"given":"Andrea","family":"Ticinesi","sequence":"additional","affiliation":[{"name":"Department of Continuity of Care and Multicomplexity, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy"},{"name":"GRETA Research Group on Thoracic Ultrasound in the Elderly, Italian 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J. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.14336\/AD.2016.1215","article-title":"Aging Airways: Between Normal and Disease. A Multidimensional Diagnostic Approach by Combining Clinical, Functional, and Imaging Data","volume":"8","author":"Occhipinti","year":"2017","journal-title":"Aging Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1177\/1479972316679664","article-title":"Sarcopenia and frailty in chronic respiratory disease","volume":"14","author":"Bone","year":"2017","journal-title":"Chronic Respir. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2300442","DOI":"10.1183\/13993003.00442-2023","article-title":"European Respiratory Society statement on frailty in adults with chronic lung disease","volume":"63","author":"Osadnik","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jemermed.2018.09.009","article-title":"Lung Ultrasound for the Emergency Diagnosis of Pneumonia, Acute Heart Failure, and Exacerbations of Chronic Obstructive Pulmonary Disease\/Asthma in Adults: A Systematic Review and Meta-analysis","volume":"56","author":"Staub","year":"2019","journal-title":"J. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.jamda.2019.06.018","article-title":"The Geriatric Patient: The Ideal One for Chest Ultrasonography? A Review From the Chest Ultrasound in the Elderly Study Group (GRETA) of the Italian Society of Gerontology and Geriatrics (SIGG)","volume":"21","author":"Ticinesi","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/jum.16088","article-title":"New International Guidelines and Consensus on the Use of Lung Ultrasound","volume":"42","author":"Demi","year":"2023","journal-title":"J. Ultrasound Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e4153","DOI":"10.1097\/MD.0000000000004153","article-title":"Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward","volume":"95","author":"Ticinesi","year":"2016","journal-title":"Medicine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2855","DOI":"10.1111\/jgs.16783","article-title":"Pneumonia Lung Ultrasound Score (PLUS): A New Tool for Detecting Pneumonia in the Oldest Patients","volume":"68","author":"Linsalata","year":"2020","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mazzarone, T., Morelli, V., Giusti, A., Bianco, M.G., Maccioni, L., Cargiolli, C., Guarino, D., Virdis, A., and Okoye, C. (2023). Predicting In-Hospital Acute Heart Failure Worsening in the Oldest Old: Insights from Point-of-Care Ultrasound. J. Clin. Med., 12.","DOI":"10.3390\/jcm12237423"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/resp.12916","article-title":"Prevalence and outcomes of diaphragmatic dysfunction assessed by ultrasound technology during acute exacerbation of COPD: A pilot study","volume":"22","author":"Antenora","year":"2017","journal-title":"Respirology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s11739-024-03531-9","article-title":"Diaphragmatic ultrasound evaluation in acute heart failure: Clinical and functional associations","volume":"19","author":"Scarlata","year":"2024","journal-title":"Intern. Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"842","DOI":"10.4081\/mrm.2022.842","article-title":"Diaphragmatic excursion by ultrasound: Reference values for the normal population; a cross-sectional study in Egypt","volume":"17","author":"Kabil","year":"2022","journal-title":"Multidiscip. Respir. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s40520-020-01565-5","article-title":"Diaphragmatic muscle thickness in older people with and without sarcopenia","volume":"33","author":"Deniz","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ggi.14519","article-title":"Respiratory sarcopenia: A position paper by four professional organizations","volume":"23","author":"Sato","year":"2023","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1159\/000518516","article-title":"Prognostic Significance of Chest Imaging by LUS and CT in COVID-19 Inpatients: The ECOVID Multicenter Study","volume":"101","author":"Tana","year":"2022","journal-title":"Respiration"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.medcli.2023.01.024","article-title":"Lung ultrasound score severity cut-off points in COVID-19 pneumonia. A systematic review and validating cohort","volume":"160","year":"2023","journal-title":"Med. Clin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.chest.2017.08.028","article-title":"Diaphragm and lung ultrasound to predict weaning outcome: Systematic review and meta-analysis","volume":"152","year":"2017","journal-title":"Chest"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"190049","DOI":"10.1183\/16000617.0049-2019","article-title":"Sarcopenia in COPD: A systematic review and meta-analysis","volume":"28","author":"Benz","year":"2019","journal-title":"Eur. Respir. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1002\/ehf2.13255","article-title":"Sarcopenia in heart failure: A systematic review and meta-analysis","volume":"8","author":"Zhang","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1002\/jcsm.13041","article-title":"The current use of ultrasound to measure skeletal muscle and its ability to predict clinical outcomes: A systematic review","volume":"13","author":"Casey","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"110678","DOI":"10.1016\/j.exger.2019.110678","article-title":"The usefulness of muscle architecture assessed with ultrasound to identify hospitalized older adults with physical decline","volume":"125","author":"Martel","year":"2019","journal-title":"Exp. Gerontol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1164\/rccm.201802-0227LE","article-title":"Training for lung ultrasound score measurement in critically ill patients","volume":"198","author":"Rouby","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00134-012-2513-4","article-title":"International evidence-based recommendations for point-of-care lung ultrasound","volume":"38","author":"Volpicelli","year":"2012","journal-title":"Intensive Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1002\/jum.15285","article-title":"Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method","volume":"39","author":"Soldati","year":"2020","journal-title":"J. Ultrasound Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1159\/000509223","article-title":"Lung Ultrasound in COVID-19 Pneumonia: Correlations with Chest CT on Hospital admission","volume":"99","author":"Nouvenne","year":"2020","journal-title":"Respiration"},{"key":"ref_28","first-page":"e65431","article-title":"Measuring diaphragm thickness and function using point-of-care ultrasound","volume":"201","author":"Bellissimo","year":"2023","journal-title":"J. Vis. Exp."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Siniscalchi, C., Nouvenne, A., Cerundolo, N., Meschi, T., Ticinesi, A., and Parma Post-Graduate Specialization School In Emergency-Urgency Medicine Interest Group On Thoracic Ultrasound (2024). Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients. Geriatrics, 9.","DOI":"10.3390\/geriatrics9030070"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s40520-018-0958-1","article-title":"Assessing sarcopenia with vastus lateralis muscle ultrasound: An operative protocol","volume":"30","author":"Ticinesi","year":"2018","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1111\/j.1532-5415.2008.01935.x","article-title":"A manual of guidelines to score the modified cumulative illness rating scale and its validation in acute hospitalized elderly patients","volume":"56","author":"Salvi","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Vetrano, D.L., Zucchelli, A., Onder, G., Fratiglioni, L., Calder\u00f3n-Larra\u00f1aga, A., Marengoni, A., Marconi, E., Cricelli, I., Lora Aprile, P., and Bernabei, R. (2023). Frailty detection among primary care older patients through the Primary Care Frailty Index (PC-FI). Sci. Rep., 13.","DOI":"10.1038\/s41598-023-30350-3"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1111\/jgs.14290","article-title":"Dyspnea in Community-Dwelling Older Persons: A Multifactorial Geriatric Health Condition","volume":"64","author":"Miner","year":"2016","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e195321","DOI":"10.1001\/jamanetworkopen.2019.5321","article-title":"Association of Undifferentiated Dyspnea in Late Life With Cardiovascular and Noncardiovascular Dysfunction: A Cross-sectional Analysis From the ARIC Study","volume":"2","author":"Ramalho","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1002\/jcu.23024","article-title":"Lung ultrasound score based on the BLUE-plus protocol is associated with the outcomes and oxygenation indices of intensive care unit patients","volume":"49","author":"Peng","year":"2021","journal-title":"J. Clin. Ultrasound"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijcard.2016.05.010","article-title":"Lung ultrasound and short-term prognosis in heart failure patients","volume":"218","author":"Cogliati","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1002\/jum.16202","article-title":"Pulmonary Congestion on Lung Ultrasound Predicts Increased Risk of 30-Day Readmission in Heart Failure Patients","volume":"42","author":"Cohen","year":"2023","journal-title":"J. Ultrasound Med."},{"key":"ref_38","first-page":"1925","article-title":"Sonographic evaluation of diaphragmatic dysfunction in COPD patients","volume":"10","author":"Scheibe","year":"2015","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.resinv.2023.12.013","article-title":"Evaluation of patients with chronic obstructive pulmonary disease by maximal inspiratory pressure and diaphragmatic excursion with ultrasound sonography","volume":"62","author":"Misuzawa","year":"2024","journal-title":"Respir. Investig."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1080\/16078454.2020.1833506","article-title":"Diaphragm ultrasonography in adults with sickle cell anemia: Evaluation of morphological and functional aspects","volume":"25","author":"Zeitoune","year":"2020","journal-title":"Hematology"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wang, B., Yin, Q., Wang, Y., Tu, Y., Han, Y., Gao, M., Pan, M., Yang, Y., Xue, Y., and Zhang, L. (2019). Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: A cross-sectional study. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-56035-4"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00134-021-06503-1","article-title":"Delirium in critical illness: Clinical manifestations, outcomes, and management","volume":"47","author":"Stolling","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.ejim.2013.12.001","article-title":"The management of community-acquired pneumonia in the elderly","volume":"25","author":"Faverio","year":"2014","journal-title":"Eur. J. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1089\/rej.2021.0063","article-title":"COVID-19 as a Paradigmatic Model of the Heterogeneous Disease Presentation in Older People: Data from the GeroCovid Observational Study","volume":"25","author":"Trevisan","year":"2022","journal-title":"Rejuvenation Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"R620","DOI":"10.1152\/ajpregu.00173.2017","article-title":"Obesity modulates diaphragm curvature in subjects with and without COPD","volume":"313","author":"Boriek","year":"2017","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Cesanelli, L., Cesanelli, F., Degens, H., and Satkunskiene, D. (2024). Obesity-related reduced spirometry and altered breathing pattern are associated with mechanical disadvantage of the diaphragm. Respir. Physiol. Neurobiol., 325.","DOI":"10.1016\/j.resp.2024.104267"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s41999-018-0126-3","article-title":"Application of ultrasound for muscle assessment in sarcopenia: The challenge of implementing protocols for clinical practice","volume":"10","author":"Ticinesi","year":"2019","journal-title":"Eur. Geriatr. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1002\/jpen.1830","article-title":"Role of Ultrasonography in Estimating Muscle Mass in Sarcopenic Obesity","volume":"44","author":"Deniz","year":"2020","journal-title":"JPEN J. Parenter. Enter. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"110801","DOI":"10.1016\/j.exger.2019.110801","article-title":"Prevalence of sarcopenia as a comorbid disease: A systematic review and meta-analysis","volume":"131","author":"Pacifico","year":"2020","journal-title":"Exp. Gerontol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"111860","DOI":"10.1016\/j.mad.2023.111860","article-title":"Assessment and risk prediction of frailty using texture-based muscle ultrasound image analysis and machine learning techniques","volume":"215","author":"Moratal","year":"2023","journal-title":"Mech. Ageing Dev."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Sim\u00f3-Servat, A., Guevara, E., Perea, V., Alonso, N., Quir\u00f3s, C., Puig-Jov\u00e9, C., and Barahona, M.J. (2023). Role of muscle ultrasound for the study of frailty in elderly patients with diabetes: A pilot study. Biology, 12.","DOI":"10.3390\/biology12060884"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Lv, S., Ling, L., Shi, H., Chen, X., Chen, S., Zhu, S., Lin, W., Lv, R., and Ding, G. (2022). Application of muscle thickness and quality measured by ultrasound in frailty assessment in China. Front. Med., 9.","DOI":"10.3389\/fmed.2022.859555"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s41999-020-00401-3","article-title":"Point-of-care ultrasound measures of muscle and frailty measures","volume":"12","author":"Madden","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Meza-Valderrama, D., Marco, E., Mu\u00f1oz-Redondo, E., Morgado-P\u00e9rez, A., Tejero S\u00e1nchez, M., Curbelo Pe\u00f1a, Y., De Jaime, E., Canchucaja, L., Meza Concepci\u00f3n, F., and Perkisas, S. (2022). Musculoskeletal ultrasound shows muscle mass changes during post-acute care hospitalization in older men: A prospective cohort study. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192215150"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ejim.2018.02.021","article-title":"Accounting for frailty when treating chronic diseases","volume":"56","author":"Onder","year":"2018","journal-title":"Eur. J. Intern. Med."},{"key":"ref_56","first-page":"486","article-title":"Frailty and chronic diseases","volume":"61","author":"Zazzara","year":"2019","journal-title":"Panminerva Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: Implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1093\/infdis\/jiaa092","article-title":"Frailty Hinders Recovery From Influenza and Acute Respiratory Illness in Older Adults","volume":"222","author":"Lees","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1136\/thoraxjnl-2020-214998","article-title":"Frailty subtypes and recovery in older survivors of acute respiratory failure: A pilot study","volume":"76","author":"Baldwin","year":"2021","journal-title":"Thorax"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"4754705","DOI":"10.1155\/2021\/4754705","article-title":"Prediction of loss of muscle mass in sarcopenia using ultrasonic diaphragm excursion","volume":"2021","author":"Zeng","year":"2021","journal-title":"Contrast Media Mol. Imaging"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Martin-Rodriguez, S., Gonzalez-Henriquez, J.J., Diaz-Conde, J.C., Calbet, J.A.L., and Sanchis-Moysi, J. (2024). The relationship between muscle thickness and pennation angle is mediated by fascicle length in the muscles of the lower extremities. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-65100-6"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/1\/87\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T15:23:49Z","timestamp":1759850629000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/1\/87"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,2]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["diagnostics15010087"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15010087","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,2]]}}}