{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:28:08Z","timestamp":1790724488752,"version":"4.1.0"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004737","name":"National Health Research Institute","doi-asserted-by":"publisher","award":["NHRI-13A1-CG-CO-04-2225-1"],"award-info":[{"award-number":["NHRI-13A1-CG-CO-04-2225-1"]}],"id":[{"id":"10.13039\/501100004737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Dengue is one of the most common epidemic infections around the world. Dengue infections in older adults are related to an atypical presentation and a high mortality. Frailty is associated with poor recovery from hospitalization due to infection. However, few studies describe frailty and functional decline after dengue infection. The current case series study aims to investigate the baseline frailty status, functional decline, and time to recovery in older adults after dengue infection. Method: We studied seven patients with post-dengue frailty who had been admitted to the geriatric ward in one tertiary medical center in Taiwan during the 2023 dengue fever outbreak. Result: The mean age was 82 years old. The clinical frailty scale worsened from a mean of 4.7 at baseline to 6.3 at dengue diagnosis. The mean Katz Index of independence in activities of daily living decreased from 10.6 at baseline to 4.7 with dengue, and it recovered to 6.7 one month after discharge. Conclusions: Our preliminary data suggest that there is indeed an increase in frailty in older adults due to dengue. Post-dengue frailty and functional decline might be profound and persistent. Acute geriatric care intervention rehabilitation for frailty after dengue may benefit this population.<\/jats:p>","DOI":"10.3390\/medicina60040537","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T11:34:58Z","timestamp":1711452898000},"page":"537","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Frailty in Older Adults with Dengue Fever"],"prefix":"10.3390","volume":"60","author":[{"given":"Yu-Sheng","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Tai","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1391-8040","authenticated-orcid":false,"given":"Yi-Ching","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-8692","authenticated-orcid":false,"given":"Jiun-Ling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 701, Taiwan"},{"name":"Department of Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1056\/NEJMra1110265","article-title":"Dengue","volume":"366","author":"Simmons","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Harapan, H., Michie, A., Sasmono, R.T., and Imrie, A. (2020). Dengue: A Minireview. Viruses, 12.","DOI":"10.3390\/v12080829"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/j.jiph.2023.08.001","article-title":"Dengue overview: An updated systemic review","volume":"16","author":"Khan","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"taab146","DOI":"10.1093\/jtm\/taab146","article-title":"Global burden for dengue and the evolving pattern in the past 30 years","volume":"28","author":"Yang","year":"2021","journal-title":"J. Travel. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.3201\/eid1810.111929","article-title":"Dengue outbreaks in high-income area, Kaohsiung City, Taiwan, 2003\u20132009","volume":"18","author":"Lin","year":"2012","journal-title":"Emerg. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.3201\/eid2908.230014","article-title":"Advanced Age and Increased Risk for Severe Outcomes of Dengue Infection, Taiwan, 2014\u20132015","volume":"29","author":"Huang","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rowe, E.K., Leo, Y.S., Wong, J.G., Thein, T.L., Gan, V.C., Lee, L.K., and Lye, D.C. (2014). Challenges in dengue fever in the elderly: Atypical presentation and risk of severe dengue and hospital-acquired infection [corrected]. PLoS Negl. Trop. Dis., 8.","DOI":"10.1371\/journal.pntd.0002777"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1111\/jgs.16950","article-title":"Persistent Functional Decline Following Hospitalization with Influenza or Acute Respiratory Illness","volume":"69","author":"Andrew","year":"2021","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1097\/MCC.0000000000000981","article-title":"Long-term recovery after critical illness in older adults","volume":"28","author":"Kaushik","year":"2022","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2265298","DOI":"10.1080\/07853890.2023.2265298","article-title":"Approach to COVID-19 in older adults and indications for improving the outcomes","volume":"55","author":"Tana","year":"2023","journal-title":"Ann. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3826","DOI":"10.1111\/jgs.18584","article-title":"Frailty as a risk factor for post-acute sequelae of COVID-19 among US veterans during the Delta and Omicron waves","volume":"71","author":"Hammel","year":"2023","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Hosoda, T., and Hamada, S. (2021). Functional decline in hospitalized older patients with coronavirus disease 2019: A retrospective cohort study. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02597-w"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s40520-020-01563-7","article-title":"Validation of shock index for predicting mortality in older patients with dengue fever","volume":"33","author":"Tan","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e7878","DOI":"10.1097\/MD.0000000000007878","article-title":"Predicting the mortality in geriatric patients with dengue fever","volume":"96","author":"Huang","year":"2017","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.4269\/ajtmh.15-0896","article-title":"Persistent Symptoms of Dengue: Estimates of the Incremental Disease and Economic Burden in Mexico","volume":"94","author":"Tiga","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kalimuddin, S., Teh, Y.E., Wee, L.E., Paintal, S., Sasisekharan, R., Low, J.G., Sheth, S.K., and Ooi, E.E. (2022). Chronic sequelae complicate convalescence from both dengue and acute viral respiratory illness. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010724"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1177\/0049475514522225","article-title":"Loss of appetite and strength in the geriatric population: Diagnostic symptoms for dengue","volume":"44","author":"Hotchandani","year":"2014","journal-title":"Trop. Doct."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Chien, Y.W., Shih, H.I., Wang, Y.P., and Chi, C.Y. (2023). Re-examination of the risk of dementia after dengue virus infection: A population-based cohort study. PLoS Negl. Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011788"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"361","DOI":"10.4269\/ajtmh.16-1018","article-title":"Differences in Mortality and Clinical Manifestations of Dengue Hemorrhagic Fever in Taiwan in Different Years: A Comparison for Cases in 2014 and 2015 Epidemics","volume":"97","author":"Chang","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/j.1748-3743.2007.00074.x","article-title":"A comparative review of the Katz ADL and the Barthel Index in assessing the activities of daily living of older people","volume":"2","author":"Hartigan","year":"2007","journal-title":"Int. J. Older People Nurs."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Church, S., Rogers, E., Rockwood, K., and Theou, O. (2020). A scoping review of the Clinical Frailty Scale. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01801-7"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"CMAJ"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pitchumoni, C.S., and Dharmarajan, T.S. (2020). Geriatric Gastroenterology, Springer International Publishing.","DOI":"10.1007\/978-3-319-90761-1"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Mendez, M. (2022). The Mental Status Examination Handbook, Elsevier.","DOI":"10.1016\/B978-0-323-69489-6.00005-X"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"693","DOI":"10.2147\/CIA.S196770","article-title":"Mini Nutritional Assessment Scale-Short Form can be useful for frailty screening in older adults","volume":"14","author":"Soysal","year":"2019","journal-title":"Clin. Interv. Aging"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying confusion: The confusion assessment method. A new method for detection of delirium","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1159\/000314963","article-title":"Properties of the \u2018timed up and go\u2019 test: More than meets the eye","volume":"57","author":"Herman","year":"2011","journal-title":"Gerontology"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Phu, S., Kirk, B., Bani Hassan, E., Vogrin, S., Zanker, J., Bernardo, S., and Duque, G. (2020). The diagnostic value of the Short Physical Performance Battery for sarcopenia. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01642-4"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Rezaei-Shahsavarloo, Z., Atashzadeh-Shoorideh, F., Ebadi, A., and Gobbens, R.J.J. (2021). Factors affecting missed nursing care in hospitalized frail older adults in the medical wards: A qualitative study. BMC Geriatr., 21.","DOI":"10.1186\/s12877-021-02524-z"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1093\/ageing\/afaa112","article-title":"Frailty, a multisystem ageing syndrome","volume":"49","author":"Thillainadesan","year":"2020","journal-title":"Age Ageing"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e3399","DOI":"10.1590\/1518-8345.3612.3399","article-title":"Hospitalized older adult: Predictors of functional decline","volume":"29","author":"Tavares","year":"2021","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"M569","DOI":"10.1093\/gerona\/57.9.M569","article-title":"Predictors of functional decline in hospitalized elderly patients: A systematic review","volume":"57","author":"McCusker","year":"2002","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/j.1365-2702.2006.01579.x","article-title":"A systematic review of predictors and screening instruments to identify older hospitalized patients at risk for functional decline","volume":"16","author":"Hoogerduijn","year":"2007","journal-title":"J. Clin. Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Hunold, K.M., Schwaderer, A.L., Exline, M., Hebert, C., Lampert, B.C., Southerland, L.T., Stephens, J.A., Boyer, E.W., Gure, T.R., and Mion, L.C. (J. Am. Geriatr. Soc., 2024). Functional decline in older adults with suspected pneumonia at emergency department presentation, J. Am. Geriatr. Soc., online ahead of print.","DOI":"10.1111\/jgs.18798"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1111\/j.1532-5415.2006.00797.x","article-title":"Assessment of pneumonia in older adults: Effect of functional status","volume":"54","author":"Mody","year":"2006","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/ggi.13227","article-title":"Identification of prognostic factors for activities of daily living in elderly patients after hospitalization for acute infectious disease in Japan: A 6-month follow-up study","volume":"18","author":"Goto","year":"2018","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1046\/j.1532-5415.2001.4911239.x","article-title":"Medical comorbidity and rehabilitation efficiency in geriatric inpatients","volume":"49","author":"Patrick","year":"2001","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Rezaei-Shahsavarloo, Z., Atashzadeh-Shoorideh, F., Gobbens, R.J.J., Ebadi, A., and Ghaedamini Harouni, G. (2020). The impact of interventions on management of frailty in hospitalized frail older adults: A systematic review and meta-analysis. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-01935-8"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s12603-021-1590-x","article-title":"Exercise, Aging and Frailty: Guidelines for Increasing Function","volume":"25","author":"Merchant","year":"2021","journal-title":"J. Nutr. Health Aging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1111\/j.1532-5415.2004.52401.x","article-title":"A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department--the DEED II study","volume":"52","author":"Caplan","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.arr.2013.06.004","article-title":"Frailty and cognitive impairment--a review of the evidence and causal mechanisms","volume":"12","author":"Robertson","year":"2013","journal-title":"Ageing Res. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"ofad490","DOI":"10.1093\/ofid\/ofad490","article-title":"Dengue Encephalopathy or Dengue Encephalitis? You Decide","volume":"10","author":"Durkin","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/imm.12748","article-title":"Pathogenesis of vascular leak in dengue virus infection","volume":"151","author":"Malavige","year":"2017","journal-title":"Immunology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"E285","DOI":"10.1503\/cmaj.170994","article-title":"Risk of stroke in patients with dengue fever: A population-based cohort study","volume":"190","author":"Li","year":"2018","journal-title":"CMAJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1093\/gerona\/glp115","article-title":"Factors associated with recovery of prehospital function among older persons admitted to a nursing home with disability after an acute hospitalization","volume":"64","author":"Gill","year":"2009","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_47","first-page":"559","article-title":"The association between cognitive impairment and functional outcome in hospitalised older patients: A systematic review and meta-analysis","volume":"46","author":"Hartley","year":"2017","journal-title":"Age Ageing"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Dasgupta, M. (2016). Cognitive Impairment in Hospitalized Seniors. Geriatrics, 1.","DOI":"10.3390\/geriatrics1010004"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Wei, K.C., Sy, C.L., Wang, W.H., Wu, C.L., Chang, S.H., and Huang, Y.T. (2022). Major acute cardiovascular events after dengue infection-A population-based observational study. PLoS Negl. Trop. Dis., 16.","DOI":"10.1371\/journal.pntd.0010134"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1016\/j.jiph.2023.07.003","article-title":"Reinvestigation of the risk of stroke after dengue virus infection: A population-based cohort study","volume":"16","author":"Chien","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"3856","DOI":"10.1093\/eurheartj\/ehab468","article-title":"Frailty and cardiovascular outcomes in the National Health and Aging Trends Study","volume":"42","author":"Damluji","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.arr.2016.08.006","article-title":"Inflammation and frailty in the elderly: A systematic review and meta-analysis","volume":"31","author":"Soysal","year":"2016","journal-title":"Ageing Res. Rev."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1111\/j.1532-5415.2008.01673.x","article-title":"T-lymphocytes expressing CC chemokine receptor-5 are increased in frail older adults","volume":"56","author":"Wang","year":"2008","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"de-Oliveira-Pinto, L.M., Marinho, C.F., Povoa, T.F., de Azeredo, E.L., de Souza, L.A., Barbosa, L.D., Motta-Castro, A.R., Alves, A.M., \u00c1vila, C.A., and de Souza, L.J. (2012). Regulation of inflammatory chemokine receptors on blood T cells associated to the circulating versus liver chemokines in dengue fever. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038527"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.2217\/fmb.15.105","article-title":"Dengue: An update on treatment options","volume":"10","author":"Chan","year":"2015","journal-title":"Future Microbiol."},{"key":"ref_56","first-page":"920","article-title":"Frailty affects the initial treatment response and time to recovery of mobility in acutely ill older adults admitted to hospital","volume":"46","author":"Hatheway","year":"2017","journal-title":"Age Ageing"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/537\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:18:48Z","timestamp":1760105928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,26]]},"references-count":56,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["medicina60040537"],"URL":"https:\/\/doi.org\/10.3390\/medicina60040537","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,26]]}}}