Zhanar Mombiyeva

Background/Objectives: Accurately assessing the independence level of older adults using useful assessment tools is an important step toward providing them with the necessary care while preserving their dignity. These tools allow older adults to receive effective, personalized home care, which improves their quality of life. This study aimed to clarify the current prevalence of severe and complete functional dependence and associated factors among Kazakhstan’s older adults aged >60 years. Methods: This cross-sectional study was conducted in several polyclinics and geriatric service care centers in two cities of Kazakhstan from March to May 2024. Functional status was assessed by the Barthel Index. We combined the selection into two categories: total dependency and severe dependency in the category “dependent”, and moderate dependency, slight dependency, and total independence in the category “active patients”. Results: Among the 642 older people in this study, 43.3% were dependent patients, and 56.7% were active patients. The odds of severe and total functional dependence are significantly higher for frail participants (adjusted odds ratio (AOR) = 2.96, 95% confidence interval (CI) [1.70, 5.16], p < 0.001) compared to those that are not frail; eleven times higher for those at home (AOR =11.90, 95% CI [5.77, 24.55], p < 0.001) than those in nursing homes; two times higher for participants with sarcopenia (AOR =2.61, 95% CI [1.49, 4.55], p < 0.001) compared to those with no sarcopenia; and three times higher for participants with high risk of fracture (AOR =3.30, 95% CI [1.94, 5.61], p < 0.001) compared to those with low risk. The odds of having severe and total functional dependence are significantly higher for participants with low dynamometry (AOR =1.05, 95% CI [1.03, 1.07], p < 0.001) compared to those with normal dynamometry. Conclusions: Old age, low dynamometry (for men ≤ 29 kg, for women ≤ 17 kg), frailty, being at home, high risk of fracture and osteoporosis, and sarcopenia were associated with increased risk of severe and total functional dependence.

Background and Objectives: The aim of this study is to categorize and combine (according to the source of biomaterial) biomarkers of frailty syndrome and identify challenges in research on these biomarkers by reviewing the current literature from the past five years. Methods: We systematically searching five electronic databases—PubMed, Scopus, Web of Science, CINAHL, and the Cochrane Library—for citations from 1 January 2019 to 1 July 2024. We conducted a qualitative data synthesis and categorized the limitations by topics and subtopics. PROSPERO—CRD: 42024491369. Results: A total of 61 papers met the criteria for inclusion in this study. These studies included a total of 56,758 participants, and 1479 unique biomarkers. We categorized biomarkers such as blood, genetic, urinary, and salivary biomarkers. Our analysis identified three major categories of challenges: challenges related to study design, unclear pathophysiological mechanisms, and biomarker-specific challenges. Conclusions: This review underscores the extensive research into biomarkers associated with frailty syndrome, such as blood, genetic, urinary, and salivary biomarkers. However, significant challenges persist, including methodological inconsistencies, biomarker measurement variability, and a limited understanding of underlying mechanisms.