***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Background Age-related declines in lean body mass appear to be more rapid in men than in women but our underst and ing of muscle mass and function among different subgroups of men and their changes with age is quite limited . The objective of this analysis is to examine racial/ethnic differences and racial/ethnic group-specific cross-sectional age differences in measures of muscle mass , muscle strength , and physical function among men . Methods Data were obtained from the Boston Area Community Health/Bone ( BACH/Bone ) Survey , a population -based , cross-sectional , observational survey . Subjects included 1,157 black , Hispanic , and white r and omly-selected Boston men ages 30 - 79 y. Lean mass was assessed by  dual-energy x-ray absorptiometry .  Upper extremity ( grip ) strength was assessed with a h and dynamometer and lower extremity physical function was derived from walk and chair st and tests .  Upper extremity strength and lower extremity physical function were also indexed by lean mass and lean mass was indexed by the square of height . Results Mean age of the sample was 47.5 y. Substantial cross-sectional age differences in grip strength and physical function were consistent across race/ethnicity . Racial/ethnic differences , with and without adjustment for covariates , were evident in all outcomes except grip strength . Racial differences in lean mass did not translate into parallel differences in physical function . For instance , multivariate modeling ( with adjustments for age , height , fat mass , self-rated health and physical activity ) indicated that whereas total body lean mass was 2.43 kg ( approximately 5 % ) higher in black compared with white men , black men had a physical function score that was approximately 20 % lower than white men . Conclusions In spite of lower levels of lean mass , the higher levels of physical function observed among white compared with non-white men in this study appear to be broadly consistent with known racial/ethnic differences in outcomes Purpose To examine the impact of systematic medication reconciliations upon hospital admission and of a medication review while in hospital on the number of inappropriate medications and unscheduled drug-related hospital revisits in elderly patients . Methods This was a prospect i ve , controlled study in 210 patients , aged 65 years or older , who were admitted to one of three internal medicine wards at a University Hospital in Sweden . Intervention patients received the complete Lund Integrated Medicines Management model ( medication reconciliation upon admission and discharge , and medication review and monitoring ) provided by a multi-professional team , including a clinical pharmacist . Control patients received st and ard care and medication reconciliation upon discharge . Blinded review ers evaluated the appropriateness of the prescribing ( using the Medication Appropriateness Index ) on admission and discharge , and assessed the probability that a drug-related problem was the reason for any patient readmitted to hospital or visiting the emergency department within 3 months of discharge ( using World Health Organisation causality criteria ) . Results There was a greater decrease in the number of inappropriate drugs in the intervention group than in the control group for both the intention-to-treat population { 51 % [ 95 % confidence interval ( CI ) 43–58 % ] vs. 39 % ( 95 % CI 30–48 % ) ; p = 0.0446 } and the per- protocol population [ 60 % ( 95 % CI 51–67 % ) vs. 44 % ( 95 % CI 34–52 % ) ; p = 0.0106 ) ] . There were six revisits to hospital in the intervention group which were judged as ‘ possibly , probably or certainly drug-related ’ , compared with 12 in the control group ( p = 0.0469 ) . Conclusions In this study , medication reconciliation and review provided by a clinical pharmacist in a multi-professional team significantly reduced the number of inappropriate drugs and unscheduled drug-related hospital revisits among elderly patients BACKGROUND Potentially inappropriate medications and prescription omissions ( PO ) are highly prevalent in older patients with mental comorbidities . OBJECTIVE To evaluate the effect of interdisciplinary geriatric and psychiatric care on the appropriateness of prescribing . DESIGN Prospect i ve and interventional study . SETTING Medical-psychiatric unit in an academic geriatric department . PARTICIPANTS Participants were 150 consecutive acutely ill patients aged on average 80.0 ± 8.1 years suffering from mental comorbidities and hospitalized for any acute somatic condition . INTERVENTION From admission to discharge , daily collaboration provided by senior geriatrician and psychiatrist working in a usual geriatric interdisciplinary care team .  MEASUREMENTS Potentially inappropriate medications and PO were detected and recorded by a trained independent investigator using STOPP/START criteria at admission and discharge . RESULTS Compared with admission , the intervention reduced the total number of medications prescribed at discharge from 1347 to 790 ( P < .0001 ) and incidence rates for potentially inappropriate medications and PO reduced from 77 % to 19 % ( P < .0001 ) and from 65 % to 11 % ( P < .0001 ) , respectively . Independent predictive factors for PIP at discharge were being a faller ( odds ratio [ OR ] 1.85 ; 95 % confidence interval [ CI ] 1.43 - 2.09 ) and for PO , the increased number of medications ( OR 1.54 ; 95 % CI 1.13 - 1.89 ) and a Charlson comorbidity index greater than 2 ( OR 1.85 ; 95 % CI 1.38 - 2.13 ) . Dementia and /or presence of psychiatric comorbidities were predictive factors for both potentially inappropriate medications and PO at discharge . CONCLUSION These findings hold substantial promise for the prevention of IP and OP in such a comorbid and polymedicated population . Further evaluations are , however , still needed to determine if such an intervention reduces potentially inappropriate prescribing medication-related outcomes , such as incidence of adverse drug events , rehospitalization , or mortality BACKGROUND Reduced muscular strength , as measured by grip strength , has been associated with an increased risk of all-cause and cardiovascular mortality . Grip strength is appealing as a simple , quick , and inexpensive means of stratifying an individual 's risk of cardiovascular death . However , the prognostic value of grip strength with respect to the number and range of population s and confounders is unknown . The aim of this study was to assess the independent prognostic importance of grip strength measurement in socioculturally and economically diverse countries . METHODS The Prospect i ve Urban-Rural Epidemiology ( PURE ) study is a large , longitudinal population study done in 17 countries of varying incomes and sociocultural setting s. We enrolled an unbiased sample of households , which were eligible if at least one household member was aged 35 - 70 years and if household members intended to stay at that address for another 4 years .  Participants were assessed for grip strength , measured using a Jamar dynamometer . During a median follow-up of 4.0 years ( IQR 2.9 - 5.1 ) , we assessed all-cause mortality , cardiovascular mortality , non-cardiovascular mortality , myocardial infa rct ion , stroke , diabetes , cancer , pneumonia , hospital admission for pneumonia or chronic obstructive pulmonary disease ( COPD ) , hospital admission for any respiratory disease ( including COPD , asthma , tuberculosis , and pneumonia ) , injury due to fall , and fracture . Study outcomes were adjudicated using source documents by a local investigator , and a subset were adjudicated central ly . FINDINGS Between January , 2003 , and December , 2009 , a total of 142,861 participants were enrolled in the PURE study , of whom 139,691 with known vital status were included in the analysis . During a median follow-up of 4.0 years ( IQR 2.9 - 5.1 ) , 3379 ( 2 % ) of 139,691 participants died . After adjustment , the association between grip strength and each outcome , with the exceptions of cancer and hospital admission due to respiratory illness , was similar across country-income strata . Grip strength was inversely associated with all-cause mortality ( hazard ratio per 5 kg reduction in grip strength 1.16 , 95 % CI 1.13 - 1.20 ; p<0.0001 ) , cardiovascular mortality ( 1.17 , 1.11 - 1.24 ; p<0.0001 ) , non-cardiovascular mortality ( 1.17 , 1.12 - 1.21 ; p<0.0001 ) , myocardial infa rct ion ( 1.07 , 1.02 - 1.11 ; p=0.002 ) , and stroke ( 1.09 , 1.05 - 1.15 ; p<0.0001 ) . Grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure . We found no significant association between grip strength and incident diabetes , risk of hospital admission for pneumonia or COPD , injury from fall , or fracture . In high-income countries , the risk of cancer and grip strength were positively associated ( 0.916 , 0.880 - 0.953 ; p<0.0001 ) , but this association was not found in middle-income and low-income countries . INTERPRETATION This study suggests that measurement of grip strength is a simple , inexpensive risk-stratifying method for all-cause death , cardiovascular death , and cardiovascular disease . Further research is needed to identify determinants of muscular strength and to test whether improvement in strength reduces mortality and cardiovascular disease . FUNDING Full funding sources listed at end of paper ( see Acknowledgments ) Background Appropriateness of prescribing can be assessed by various measures and screening instruments . The aims of this study were to investigate the effects of pharmacists ' interventions on appropriateness of prescribing in elderly patients , and to explore the relationship between these results and hospital care utilization during a 12-month follow-up period . Methods The study population from a previous r and omized controlled study , in which the effects of a comprehensive pharmacist intervention on re-hospitalization was investigated , was used . The criteria from the instruments MAI , STOPP and START were applied retrospectively to the 368 study patients ( intervention group ( I ) n = 182 , control group ( C ) n = 186 ) . The assessment s were done on admission and at discharge to detect differences over time and between the groups . Hospital care consumption was recorded and the association between scores for appropriateness , and hospitalization was analysed . Results The number of Potentially Inappropriate Medicines ( PIMs ) per patient as identified by STOPP was reduced for I but not for C ( 1.42 to 0.93 vs. 1.46 to 1.66 respectively , p<0.01 ) . The number of Potential Prescription Omissions ( PPOs ) per patient as identified by START was reduced for I but not for C ( 0.36 to 0.09 vs. 0.42 to 0.45 respectively , p<0.001 ) . The summated score for MAI was reduced for I but not for C ( 8.5 to 5.0 and 8.7 to 10.0 respectively , p<0.001 ) . There was a positive association between scores for MAI and STOPP and drug-related readmissions ( RR 8–9 % and 30–34 % respectively ) . No association was detected between the scores of the tools and total re-visits to hospital . Conclusion The interventions significantly improved the appropriateness of prescribing for patients in the intervention group as evaluated by the instruments MAI , STOPP and START . High scores in MAI and STOPP were associated with a higher number of drug-related readmissions PURPOSE To determine if inpatient or outpatient geriatric evaluation and management , as compared with usual care , reduces adverse drug reactions and suboptimal prescribing in frail elderly patients . METHODS The study employed a r and omized 2 x 2 factorial controlled design . Subjects were patients in 11 Veterans Affairs ( VA ) hospitals who were > or = 65 years old and met criteria for frailty ( n = 834 ) .  Inpatient geriatric unit and outpatient geriatric clinic teams evaluated and managed patients according to published guidelines and VA st and ards . Patients were followed for 12 months . Blinded physician-pharmacist pairs rated adverse drug reactions for causality ( using Naranjo 's algorithm ) and seriousness . Suboptimal prescribing measures included unnecessary and inappropriate drug use ( Medication Appropriateness Index ) , inappropriate drug use ( Beers criteria ) , and underuse . RESULTS For serious adverse drug reactions , there were no inpatient geriatric unit effects during the inpatient or outpatient follow-up periods . Outpatient geriatric clinic care result ed in a 35 % reduction in the risk of a serious adverse drug reaction compared with usual care ( adjusted relative risk = 0.65 ; 95 % confidence interval : 0.45 to 0.93 ) . Inpatient geriatric unit care reduced unnecessary and inappropriate drug use and underuse significantly during the inpatient period ( P < 0.05 ) . Outpatient geriatric clinic care reduced the number of conditions with omitted drugs significantly during the outpatient period ( P < 0.05 ) . CONCLUSION Compared with usual care , outpatient geriatric evaluation and management reduces serious adverse drug reactions , and inpatient and outpatient geriatric 
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INTERPRETATION our findings support the use of our British grip strength centiles and their associated cut points in consensus definitions for sarcopenia and frailty across developed regions , but highlight the need for different cut points in developing regions