Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 15 Dec 2020
Reviewer's report:
Thank you for this interesting work. The manuscript is well written and focuses on an important
and understudied area of frailty research.  I have a couple suggestions regarding reporting the
characteristics in the results and in Table 1 in order to strengthen the findings and possibly to
better elucidate the association between frailty and CC. First, it would be helpful to include
categorical frailty: robust, N (%); pre-frail, N (%); and frail, N (%).  Second, it would also be
helpful to include the same information for each of the five frailty components: slowness, N
(%), etc.  This would provide a better understanding of what frailty items are most common,
and perhaps, may be contributing most to this association.
I have added specific comments below.
On page 2, in the abstract results, the word "both" seems unnecessary.
On page 4, can you please clarify what is meant by "systematic aging per se"?
One page 6, it should be noted that the criteria used in this study follow the five main CHS frailty
phenotype criteria but with modifications. For example, use of a a different physical activity
scale; no stratification for walking speed by sex or height.  This is not a major concern but it
should noted that it is not identical to the CHS assessment.
On page 7, does the depressive mood assessment include the 2 exhaustion questions in the frailty
assessment?  Seeing that you did not adjust for depression in the logistic regression analysis,
this should be fine.
On page 10, the word "fall" should be "falls".
On pages 11, a minor suggestion is to change the word "researches" to "research".
In Table 1, please consider adding frailty by category (robust, pre-frail, frail) as well.  I do see
this is captured in Figure 1B. Also, per above, please consider adding frailty components.
In Table 2, please consider including all odds ratios and CIs, even if not statistically significant,
unless it is the journal policy to report NS.
Thank you.
Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 15 Dec 2020
Reviewer's report:
Thank you for this interesting work. The manuscript is well written and focuses on an important
and understudied area of frailty research.  I have a couple suggestions regarding reporting the
characteristics in the results and in Table 1 in order to strengthen the findings and possibly to
better elucidate the association between frailty and CC. First, it would be helpful to include
categorical frailty: robust, N (%); pre-frail, N (%); and frail, N (%).  Second, it would also be
helpful to include the same information for each of the five frailty components: slowness, N
(%), etc.  This would provide a better understanding of what frailty items are most common,
and perhaps, may be contributing most to this association.
I have added specific comments below.
On page 2, in the abstract results, the word "both" seems unnecessary.
On page 4, can you please clarify what is meant by "systematic aging per se"?
One page 6, it should be noted that the criteria used in this study follow the five main CHS frailty
phenotype criteria but with modifications. For example, use of a a different physical activity
scale; no stratification for walking speed by sex or height.  This is not a major concern but it
should noted that it is not identical to the CHS assessment.
On page 7, does the depressive mood assessment include the 2 exhaustion questions in the frailty
assessment?  Seeing that you did not adjust for depression in the logistic regression analysis,
this should be fine.
On page 10, the word "fall" should be "falls".
On pages 11, a minor suggestion is to change the word "researches" to "research".
In Table 1, please consider adding frailty by category (robust, pre-frail, frail) as well.  I do see
this is captured in Figure 1B. Also, per above, please consider adding frailty components.
In Table 2, please consider including all odds ratios and CIs, even if not statistically significant,
unless it is the journal policy to report NS.
Thank you.
Please review this paper.
user
Title: Higher Frailty Burden in Older Adults with Chronic Constipation
Version: 1 Date: 15 Dec 2020
Reviewer's report:
Thank you for this interesting work. The manuscript is well written and focuses on an important
and understudied area of frailty research.  I have a couple suggestions regarding reporting the
characteristics in the results and in Table 1 in order to strengthen the findings and possibly to
better elucidate the association between frailty and CC. First, it would be helpful to include
categorical frailty: robust, N (%); pre-frail, N (%); and frail, N (%).  Second, it would also be
helpful to include the same information for each of the five frailty components: slowness, N
(%), etc.  This would provide a better understanding of what frailty items are most common,
and perhaps, may be contributing most to this association.
I have added specific comments below.
On page 2, in the abstract results, the word "both" seems unnecessary.
On page 4, can you please clarify what is meant by "systematic aging per se"?
One page 6, it should be noted that the criteria used in this study follow the five main CHS frailty
phenotype criteria but with modifications. For example, use of a a different physical activity
scale; no stratification for walking speed by sex or height.  This is not a major concern but it
should noted that it is not identical to the CHS assessment.
On page 7, does the depressive mood assessment include the 2 exhaustion questions in the frailty
assessment?  Seeing that you did not adjust for depression in the logistic regression analysis,
this should be fine.
On page 10, the word "fall" should be "falls".
On pages 11, a minor suggestion is to change the word "researches" to "research".
In Table 1, please consider adding frailty by category (robust, pre-frail, frail) as well.  I do see
this is captured in Figure 1B. Also, per above, please consider adding frailty components.
In Table 2, please consider including all odds ratios and CIs, even if not statistically significant,
unless it is the journal policy to report NS.
Thank you.
assistant