{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T05:10:42Z","timestamp":1759813842235},"reference-count":36,"publisher":"AACN Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Identifying potentially modifiable factors that mediate adverse outcomes in frail adults with critical illness may facilitate development of interventions to improve intensive care unit (ICU) survivorship.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To estimate the relationship between frailty, acute brain dysfunction (as reflected by delirium or persistent coma), and 6-month disability outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Older adults (aged \u226550 years) admitted to the ICU were enrolled prospectively. Frailty was identified with the Clinical Frailty Scale. Delirium and coma were assessed daily with the Confusion Assessment Method for the ICU and the Richmond Agitation-Sedation Scale, respectively. Disability outcomes (death and severe physical disability [defined as new dependence in 5 or more activities of daily living]) were assessed by telephone within 6 months after discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In 302 older adults (mean [SD] age, 67.2 [10.8] y), both frail and vulnerable patients had a higher risk for acute brain dysfunction (adjusted odds ratio [AOR], 2.9 [95% CI, 1.5-5.6], and 2.0 [95% CI, 1.0-4.1], respectively) compared with fit patients. Both frailty and acute brain dysfunction were independently associated with death or severe disability at 6 months (AOR, 3.3 [95% CI, 1.6-6.5] and 2.4 [95% CI, 1.4 -4.0], respectively). The average proportion of the frailty effect mediated by acute brain dysfunction was estimated to be 12.6% (95% CI, 2.1%-23.1%; P = .02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Frailty and acute brain dysfunction were important independent predictors of disability outcomes in older adults with critical illness. Acute brain dysfunction may be an important mediator of increased risk for physical disability outcomes after critical illness.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ajcc2023858","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T02:09:18Z","timestamp":1688177358000},"page":"256-263","source":"Crossref","is-referenced-by-count":6,"title":["Frailty, Acute Brain Dysfunction, and Posthospitalization Disability Outcomes in Critically Ill Older Adults"],"prefix":"10.4037","volume":"32","author":[{"given":"Corrielle","family":"Caldwell","sequence":"first","affiliation":[{"name":"Corrielle Caldwell was a critical care medicine fellow, Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, New York; she is currently an intensivist at Prisma Health, Sumter, South Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joe","family":"Verghese","sequence":"additional","affiliation":[{"name":"Joe Verghese is a professor, Department of Medicine, Division of Cognitive and Motor Aging and Geriatrics, Albert Einstein College of Medicine, Bronx, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle N.","family":"Gong","sequence":"additional","affiliation":[{"name":"Michelle N. Gong is a professor, Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, Montefiore Medical Center, and a professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mimi","family":"Kim","sequence":"additional","affiliation":[{"name":"Mimi Kim is a professor, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aluko A.","family":"Hope","sequence":"additional","affiliation":[{"name":"Aluko A. Hope is an associate professor, Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon, and this work was completed while he was at the Department of Medicine, Division of Critical Care Medicine, Montefiore Medical Center, Bronx, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"issue":"3","key":"2023070102090512800_b1-0320256","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"2023070102090512800_b2-0320256","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1186\/cc9297","article-title":"Frailty in the critically ill: a novel concept","volume":"15","author":"McDermid","year":"2011","journal-title":"Crit 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