Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 11 Jan 2021
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript. All research that furthers
our understanding of frailty is important in our ageing world. Here, using a community
dwelling population representative cross sectional cohort study, the authors evaluate chronic
constipation's relationship (prevalence/severity) with frailty. They conclude that they are
associated. Please see below for additional comments.
1. Even though the the frailty phenotype is a 5 point score, usually the focus of the scoring is
on characterizing patients into robust/pre-frail/frail and not as a 5 point scale. From what I am
able to gather some analysis was done with frailty as a continuous score. It might be worthwhile
to acknowledge this in the manuscript.
2. Study design: I would likely take out "Through annual evaluations...." sentence as I am not
sure if this is relevant to the manuscript.
3. With the FC definition of CC, two of three items had to be present. One was insufficient
symptoms to diagnose the condition as IBS that lasted for at least 3 months. Presumably they
still had to have constipation symptoms outlined in IBS-C and not other representations of IBS.
4. The methods stated that evaluated was 'general bowel habits including self-reported
constipation...' but I did not see where or how this was presented elsewhere in the manuscript
other than the prevalence of self reported constipation in the participants.
5. How would you comment on the differences between self reported constipation and CC
definition used (IBS-C / FC). Did self report constipation have similar results? Is this a normal
difference in prevalence found elsewhere in the literature?
6. What was the purpose of model 2 considering model 1 and 3 are reported.
7. The results would be more transparent if instead of 'NS' in Table 2, the OR and CI were present.
8. I would recommend simplifying some of the results lines that you repeat the full methods/
analysis methods descriptions. Your full methods were reported elsewhere. I understand if you
would like to leave this comment as is.
9. Crude model means univariable?
10. I am based toward frailty but would the discussion create the opportunity to comments
on targeting chronic constipation as a potential reversible component of frailty rather than just
using multicomponent interventions for chronic constipation? Treating constipation is a major
component of acute illness management, evaluating all elimination, including constipation is
part of comprehensive geriatric assessments and frailty interventions are highly investigated.
Thank you.
Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 11 Jan 2021
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript. All research that furthers
our understanding of frailty is important in our ageing world. Here, using a community
dwelling population representative cross sectional cohort study, the authors evaluate chronic
constipation's relationship (prevalence/severity) with frailty. They conclude that they are
associated. Please see below for additional comments.
1. Even though the the frailty phenotype is a 5 point score, usually the focus of the scoring is
on characterizing patients into robust/pre-frail/frail and not as a 5 point scale. From what I am
able to gather some analysis was done with frailty as a continuous score. It might be worthwhile
to acknowledge this in the manuscript.
2. Study design: I would likely take out "Through annual evaluations...." sentence as I am not
sure if this is relevant to the manuscript.
3. With the FC definition of CC, two of three items had to be present. One was insufficient
symptoms to diagnose the condition as IBS that lasted for at least 3 months. Presumably they
still had to have constipation symptoms outlined in IBS-C and not other representations of IBS.
4. The methods stated that evaluated was 'general bowel habits including self-reported
constipation...' but I did not see where or how this was presented elsewhere in the manuscript
other than the prevalence of self reported constipation in the participants.
5. How would you comment on the differences between self reported constipation and CC
definition used (IBS-C / FC). Did self report constipation have similar results? Is this a normal
difference in prevalence found elsewhere in the literature?
6. What was the purpose of model 2 considering model 1 and 3 are reported.
7. The results would be more transparent if instead of 'NS' in Table 2, the OR and CI were present.
8. I would recommend simplifying some of the results lines that you repeat the full methods/
analysis methods descriptions. Your full methods were reported elsewhere. I understand if you
would like to leave this comment as is.
9. Crude model means univariable?
10. I am based toward frailty but would the discussion create the opportunity to comments
on targeting chronic constipation as a potential reversible component of frailty rather than just
using multicomponent interventions for chronic constipation? Treating constipation is a major
component of acute illness management, evaluating all elimination, including constipation is
part of comprehensive geriatric assessments and frailty interventions are highly investigated.
Thank you.
Please review this paper.
user
Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 11 Jan 2021
Reviewer's report:
Thank you for giving me the opportunity to review this manuscript. All research that furthers
our understanding of frailty is important in our ageing world. Here, using a community
dwelling population representative cross sectional cohort study, the authors evaluate chronic
constipation's relationship (prevalence/severity) with frailty. They conclude that they are
associated. Please see below for additional comments.
1. Even though the the frailty phenotype is a 5 point score, usually the focus of the scoring is
on characterizing patients into robust/pre-frail/frail and not as a 5 point scale. From what I am
able to gather some analysis was done with frailty as a continuous score. It might be worthwhile
to acknowledge this in the manuscript.
2. Study design: I would likely take out "Through annual evaluations...." sentence as I am not
sure if this is relevant to the manuscript.
3. With the FC definition of CC, two of three items had to be present. One was insufficient
symptoms to diagnose the condition as IBS that lasted for at least 3 months. Presumably they
still had to have constipation symptoms outlined in IBS-C and not other representations of IBS.
4. The methods stated that evaluated was 'general bowel habits including self-reported
constipation...' but I did not see where or how this was presented elsewhere in the manuscript
other than the prevalence of self reported constipation in the participants.
5. How would you comment on the differences between self reported constipation and CC
definition used (IBS-C / FC). Did self report constipation have similar results? Is this a normal
difference in prevalence found elsewhere in the literature?
6. What was the purpose of model 2 considering model 1 and 3 are reported.
7. The results would be more transparent if instead of 'NS' in Table 2, the OR and CI were present.
8. I would recommend simplifying some of the results lines that you repeat the full methods/
analysis methods descriptions. Your full methods were reported elsewhere. I understand if you
would like to leave this comment as is.
9. Crude model means univariable?
10. I am based toward frailty but would the discussion create the opportunity to comments
on targeting chronic constipation as a potential reversible component of frailty rather than just
using multicomponent interventions for chronic constipation? Treating constipation is a major
component of acute illness management, evaluating all elimination, including constipation is
part of comprehensive geriatric assessments and frailty interventions are highly investigated.
Thank you.
assistant