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BACKGROUND: Heart failure (HF) can coexist with atrial fibrillation in up to 60 % of cases, increasing rates of hospitalizations and death. This study analyzed the clinical characteristics, treatment, hospitalization, and mortality of patients with HF and atrial fibrillation based on left ventricular ejection fraction (LVEF). METHODS: A retrospective cohort study included patients from an outpatient HF clinic at Medellín (Colombia) between 2020-2022. Patients were classified into two groups according to LVEF: reduced (LVEF≤40 %) and mildly reduced or preserved ejection fraction (LVEF>40 %). The evaluated outcomes were hospitalization and mortality during follow-up. Values for B-type natriuretic peptide (BNP), LVEF and functional class according to the New York Heart Association (NYHA) were also analyzed at admission and during the last follow-up visit. RESULTS: The study included 185 patients, with 51.9% being male. The median age of the participants was 80 years (interquartile range [IQR] 74 - 86). There was an overall improvement in the NYHA functional class, BNP levels, and LVEF compared with the baseline values, irrespective of left systolic function. Atrial fibrillation ablation was performed in 3.2 % of patients, and cardiac device implantation with atrioventricular node ablation in 29 %. No statistically significant differences were found in terms of hospitalization and mortality regarding left systolic function. CONCLUSION: Compressive optimal treatment for patients with HF and atrial fibrillation requires pharmacological treatment, ablation strategies, cardiac devices, cardiovascular rehabilitation and close follow-up. In this cohort, hospitalization and mortality rates were similar according to LVEF categories and there was improvement in NYHA functional class and BNP level.

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We observed at our university-based imaging centers that when prostate-specific membrane antigen (PSMA) PET/CT became available for staging and restaging prostate cancer, the volume of bone scanning on patients with prostate cancer (BS-P) markedly decreased. We aimed to study use patterns of PSMA PET/CT and BS-P at our imaging centers during the 4-y period around U.S. Food and Drug Administration approval of PSMA PET/CT in December 2020. We tested the hypothesis that the rate of decline of BS-P accelerated after U.S. Food and Drug Administration approval, as physicians planned for use of PSMA PET/CT in their patients. Methods: Our clinical report system was searched for BS-P and PSMA PET/CT scans from January 2019 through June 2023. Numbers of scans were tabulated by quarter and year. Quantitative and statistical analyses were performed. Results: Annualized average monthly BS-P peaked at 53.7 scans/mo in 2021 and then decreased over time. There were 552 BS-Ps performed in 2019, 503 in 2020, 614 in 2021, 481 in 2022, and 152 in the first half of 2023. BS-P monthly averages declined by 22% from 2021 to 2022 and by 36% from 2022 to 2023, whereas monthly PSMA PET/CT scan averages increased by 1,416% from 2021 to 2022 and by 69% from 2022 to 2023. There was a significantly greater decline in BS-Ps from 2022 to 2023 than from 2021 to 2022 (36% vs. 22%, P < 0.0001). There were 30 PSMA PET/CT scans performed in 2021, 455 in 2022, and 384 in the first half of 2023. The greatest quarterly increase in these scans (400%) occurred at the outset of PSMA PET/CT implementation in quarter 4 of 2021. In quarter 2 of 2023, the percentage of total studies was higher for PSMA PET/CT than for BS-P (74% vs. 26%, P < 0.0001). Conclusion: At our university-based imaging centers, use of BS-P has declined in correlation with the timing of U.S. Food and Drug Administration approval and implementation of PSMA PET/CT. This study illustrates one instance of workflow changes that occur in the nuclear medicine clinic when new agents are introduced and affect clinical management options.

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Percutaneous ultrasound-assisted carpal tunnel (CT) release is an emerging minimally invasive technique in hand surgery that could reduce complications, enhance patient satisfaction, and facilitate earlier return to daily activities. Among the various devices employed for this procedure, the Sono-Instrument allows pin-hole surgery. Its safety and effectiveness have been established. This study presents the technical nuances, pearls and pitfalls, advantages, and challenges of using the Sono-Instrument for percutaneous ultrasound-assisted CT release.

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Introduction: Data on treatment of spontaneous coronary artery dissection (SCAD) has evolved with guidance from national societies beginning around 2018. Given emerging guidance and relatively uncommon presentation of SCAD, we hypothesized that a specialized SCAD clinic would improve guidance-based care. Methods: We utilized a system-wide electronic medical record search to identify individuals with SCAD diagnosis from 2018 to 2023. All diagnostic angiograms were reviewed to verify diagnosis. We analyzed frequency of guidance-based care since 2018 system-wide. We also compared guidance-based care for individuals with index visits to the SCAD outpatient clinic as compared to non-SCAD clinic providers from initiation of specialty clinic in 2021. Results: Differences were observed in pregnancy and contraception discussions (88 % vs 0 %, p < 0.001) among pre-menopausal individuals in SCAD clinic compared to non-SCAD clinics. Safety of hormone replacement therapy (HRT) in menopausal women was addressed more by SCAD clinic providers (85 % vs 7 %, p < 0.001). There was more fibromuscular dysplasia (FMD) screening in SCAD clinic (100 % vs 30 %, p < 0.001). Among individuals with migraines, there was more discussion of triggering medications (triptans) in SCAD clinic (80 % vs 14 %, p = 0.008). In individuals prescribed statins not by primary prevention guidelines and without atherosclerosis, there was a trend toward more discussion of statin use in SCAD clinic follow up vs non-SCAD clinic providers (63 % vs 17 %, p = 0.06). Conclusions: Individuals with follow up in SCAD clinic compared to non-SCAD clinics were more likely to have future pregnancy and contraception counseling, discussion of HRT safety, and FMD screening following index outpatient visit. Future quality improvement initiatives will target these aspects of guidance-based care among non-SCAD clinic providers with integration into cardiology fellow training.

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Nonattendance at scheduled dental appointments has a significant impact on healthcare systems worldwide. This study examines the factors associated with missed appointments at the Dental Center in the Department of Oral and Dental Health in Riyadh, Saudi Arabia, through a retrospective secondary data analysis. Existing medical records from January 1, 2024, to May 1, 2024 were analyzed to identify patterns or factors contributing to nonattendance. Data were collected using a standardized sheet and analyzed with statistical methods, including correlation analysis, ANOVA, and chi-square tests, to determine significant associations and factors affecting nonattendance. The results indicated that the majority of nonattendees were single (56.2%), with a higher proportion of females (60.7%) compared to males (39.3%). Only 3.8% of those who missed their appointments were over 55 years old. Tuesdays had the highest incidence of nonattendance (331 cases). No significant association was found between age groups and the time (F = 0.224, p = 0.925) or date (F = 0.840, p = 0.500) of appointments. Patients were less likely to attend morning appointments compared to evening ones. The high rate of missed appointments reduces the effectiveness and efficiency of the Dental Center's resources. The identified patterns and factors can guide managers and policymakers in developing strategies to reduce missed appointments and improve overall appointment adherence.

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Effectiveness and limitations of a DBT-informed day-patient treatment for patients with borderline personality disorder Introduction: Borderline personality disorder, a highly prevalent personality disorder is associated with remarkable impairment and is considered one of the most challenging mental illnesses to treat. Dialectical Behavioral Therapy has been recommended by the American Psychiatric Association as a specific treatment for patients with borderline personality disorder. So far, little is known about its effectiveness in a day-patient setting. METHODS: This retrospective longitudinal study investigates changes in symptom burden during an average of 11 weeks of DBT-informed treatment at discharge, and three months after discharge. The symptomatology of n = 178 patients with borderline personality disorder treated from 2009 to 2017 was investigated with established borderline-specific (BSL) and -unspecific questionnaires (BSI-18, BDI) at admission, discharge, and 3-months follow-up by calculating mixed models, effect sizes, and response rates. RESULTS: 80 % of the patients completed the treatment regularly. In borderline-specific impairments, there were moderate and highly significant improvements with good effects and a response rate of 48 %. Approximately 20 % showed a symptom level equivalent to that of the general population. The strongest effect sizes of approximately .8 were obtained for general psychopathology, with a response rate of 66 %. Results remained stable at follow-up. DISCUSSION: Similar effects to inpatient treatment with good acceptance and efficacy could be achieved. Effect sizes differed for borderline-specific and unspecific symptoms, suggesting that DBT has different effects on different symptom areas. When comparing responders and non-responders, outpatient psychotherapy appeared to have a positive impact on the therapeutic effect. Furthermore, the results suggest that changes in borderline personality disorder extend over a longer period of time, which may indicate the limitations of curative treatment.

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Background: The Global Dementia Observatory (GDO) is a monitoring and accountability tool for the Global Action Plan on Public Response to Dementia 2017-25. Evidence from dementia registries may be utilized to better address WHO efforts in member countries, as well as to improve clinical practice and public health policy. The goal of this study was to analyze one-year data from a prospective memory clinic registry. Methods: This study was a baseline analysis of prospective memory clinics registry data of Qatar from January 1, 2023, through December 31, 2023. Results: This study investigated the demographic, clinical, and lifestyle characteristics of 464 participants who were enrolled in memory clinics. Mild neurocognitive disorders were the most prevalent diagnoses in both sexes, affecting 61.5% of male patients and 63.7% of female patients. Dementia was slightly more common in men (19.8% vs. 18.9%), although delirium was more common in women (1.9% vs. 0%). In terms of risk factors, the analysis revealed that females were more likely to be obese (36.8% vs. 16.7% in males), while males had higher rates of diabetes (61.1% vs. 51.9% in females), hypertension (69.4% vs. 62.7% in females), and smoking (17.1% vs. 3.8% in females). Conclusion: The findings of this study highlight the differences in dementia risk factors between genders and races, highlighting the need for customized interventions. Furthermore, the registry is a great resource for policymakers and healthcare professionals, providing evidence-based suggestions to improve dementia care, increase the well-being of patients and caregivers, and maximize resource allocation.

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Objective: In this study, we assessed the usefulness of a previsit questionnaire for children who were referred for an initial evaluation in a mitochondrial subspecialty clinic. We explored the themes regarding parent's questions, concerns, and goals. We aimed to add to existing knowledge about the usefulness of previsit questionnaires in a pediatric specialty setting from the perspective of parents, the specialist, and the clinical coordinator. Method: We enrolled 25 patients and their parent(s) over 25 months. Questionnaires were completed by the parent(s), the clinical coordinator, and the mitochondrial specialist. Descriptive statistics and thematic analysis were used to summarize results. Results: Parental responses suggested that they are most concerned about their child's clinical problems, communication, language and developmental delays, disease progression and prognosis, understanding mitochondrial disease, quality of life, and physical challenges including muscle and energy problems. Parents felt the previsit questionnaire was very helpful for both the doctor and for themselves to be prepared for their visit. The specialist and the clinical coordinator also found it to be helpful. Parental comments suggested that they felt that writing down the story of their child's life was helpful for the provider, allowed time for reflection, and improved the appointment experience. Some felt it was a difficult or redundant activity. Conclusion: Parents were often pleased to complete the previsit questionnaire. This allowed them to highlight concerns and share information that they wanted the care team to know about their child. We revised the tool based on feedback from parents and the specialist and will continue to use it in our clinic.

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The recent rise in telemedicine, notably during the COVID-19 pandemic, highlights the potential of integrating artificial intelligence tools in healthcare. This study assessed the effectiveness of ChatGPT versus medical oncologists in the telemedicine-based management of metastatic prostate cancer. In this retrospective study, 102 patients who met inclusion criteria were analyzed to compare the competencies of ChatGPT and oncologists in telemedicine consultations. ChatGPT's role in pre-charting and determining the need for in-person consultations was evaluated. The primary outcome was the concordance between ChatGPT and oncologists in treatment decisions. Results showed a moderate concordance (Cohen's Kappa = 0.43, p < 0.001). The number of diagnoses made by both parties was not significantly different (median number of diagnoses: 5 vs. 5, p = 0.12). In conclusion, ChatGPT exhibited moderate agreement with oncologists in management via telemedicine, indicating the need for further research to explore its healthcare applications.

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OBJECTIVES: Complementary and Alternative Medicine (CAM) is a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine. Pregnant women are vulnerable to adverse effects of medicines, especially during the first trimester. Though it is advised to avoid unnecessary intake of medicine during pregnancy, CAM use is widespread. METHODS: A cross-sectional questionnaire-based study was conducted on 120 pregnant women attending the antenatal clinic of a tertiary-care teaching hospital in Udaipur district of Southern Rajasthan, India. Women of age 18 years and above were surveyed between July 2022 to December 2023 by convenient sampling strategy and data were entered in a pretested and pre-validated questionnaire. The data were analyzed using descriptive statistics, the Chi-square test was applied to compare CAM use among different demographic categories and a p-value less than 0.05 was considered statistically significant. RESULTS: Out of 120 participants, 58 (48.33 %) were using CAM therapy. Out of 58 users, 44 (75.86 %) were using herbal & traditional medicines. Twenty (34.48 %) were using CAM for a healthy baby, 18 (31.03 %) for easy delivery and 17 (29.31 %) for boosting immunity. Forty (68.96 %) participants started CAM on the advice of a relative/friend. Fifty six (46.67 %) participants believe that CAM therapy cannot cause adverse effects on the in utero child, while 32 (26.67 %) believe that CAM and modern medicines don't interact. CONCLUSIONS: CAM use among pregnant women is substantial. There is a need to raise awareness among the healthcare professionals and pregnant women regarding possible adverse effects and drug-drug interactions with CAM use.

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Background: Depression is a leading cause of major public health problems globally, and its frequency has been increasing, particularly in low-income and middle-income countries. The prevalence of depression in sub-Saharan Africa ranges from 15 to 30%. In Ethiopia, depression is found to be the seventh leading cause of disease burden, yet no study was done in West Shewa, Ethiopia. Therefore, this study aimed to assess the magnitude of depression and associated factors among adult orthopedic outpatients getting treatment at Ambo University Referral Hospital, West Shewa, Oromia, Ethiopia, in 2023. Methods: An institution-based cross-sectional study was conducted among 391 adult orthopedic patients from January 1-30, 2023. A systematic random sampling technique was used to select the study subjects. The data were collected by using a structured questionnaire and checklist through face-to-face interviews and chart review techniques. The collected data were entered into Epi-data, version 4.6, and then exported to SPSS, version 26.0, for statistical analysis. The binary logistic regression model was fitted, and both bivariable and multivariable logistic regression analyses were employed. Result: The magnitude of depression was found to be 38.9% (95% CI: 34.5%, 43.9%), being female [adjusted odds ratio (AOR)=2.41; 95% confidence interval (CI): 1.45-4.00], chewing chat (AOR=2.39; 95% CI: 1.29-4.43), and no disorder on the lower limb (AOR=0.24; 95% CI: 0.07-0.85), had ligament injury (AOR=2.62; 95% CI: 1.23-5.59), had no complication (AOR=0.07; 95% CI: 0.01-0.52), and had amputation (AOR=3.83; 95% CI: 2.09-7.00) were significantly associated with depression. Conclusion and recommendation: The study found that the prevalence of depression among orthopedic patients was considerable; nearly half of the participants developed depression at Ambo University Referral Hospital, and being female, chewing chat, having no disorder on the lower limb, having a ligament injury, having a complication, and being amputated were significantly associated with depression. Therefore, due attention is needed from concerned bodies in order to tackle this problem.

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Background. The COVID-19 pandemic demonstrated a need for robust SARS-CoV-2 test evaluation infrastructure to underpin biosecurity and protect the population during a pandemic health emergency.Gap statement. The first generation of rapid antigen tests was less accurate than molecular methods due to their inherent sensitivity and specificity shortfalls, compounded by the consequences of self-testing. This created a need for more accurate point-of-care SARS-CoV-2 detection methods.Aim. Here we present the lessons-learned during the COVID-19 emergency response in Western Australia including the detailed set-up, evaluation and operation of rapid antigen test in a state-run drive-through sample collection service during the COVID-19 pandemic after the strict border shutdown ended.Methods. We report a conformity assessment of a novel, second-generation rapid antigen test (Virulizer) comprising a technician-operated rapid lateral flow immunoassay with fluorescence-based detection.Results. The Virulizer rapid antigen test demonstrated up to 100% sensitivity (95% CI: 61.0-100%), 91.94% specificity (95% CI: 82.5-96.5%) and 92.65% accuracy when compared to a commercial PCR assay method. Wide confidence intervals in our series reflect the limits of small sample size. Nevertheless, the Virulizer assay performance was well-suited to point-of-care screening for SARS-CoV-2 in a drive-through clinic setting.Conclusion. The adaptive evaluation process necessary under changing pandemic conditions enabled assessment of a simple sample collection and point-of-care testing process, and showed how this system could be rapidly deployed for SARS-CoV-2 testing, including to regional and remote settings.

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BACKGROUND: Pharmacist-led smoking cessation programs in pre-admission clinics (PAC) have shown to increase quit attempts and achieve abstinence by the day of surgery (DOS). AIMS: To evaluate the feasibility of Pharmacist E-script Transcription Service (PETS) initiated nicotine replacement therapy (NRT) in PAC, including smoking cessation on DOS. METHODS: A single centre, pre and post-intervention pilot study conducted at an Australian public hospital PAC. In a two-month intervention period, PAC nursing staff invited smokers (≥1 cigarette/day) to see a smoking cessation PET pharmacist. Pharmacist-initiated NRT and Quitline© referrals were offered. Cessation outcomes were compared with the preceding two-month control period. PRIMARY OUTCOME: feasibility of intervention. SECONDARY OUTCOMES: DOS smoking abstinence rates and three-months post-surgery. RESULTS: PAC nurses identified 112 smokers over 4 months; 53 during pre-intervention period, and 59 during intervention period. Twenty-two intervention patients (37%) accepted seeing the pharmacist, with 16 subsequent Quitline© referrals (73%) and 11 NRT prescriptions (50%) written. The median nursing smoking status documentation time increased in the intervention period (1 min vs. 4, p < .001). The intervention did not impact pharmacist's workload. Verified abstinence increased from 8.5% (4/47) pre-intervention to 9.4% (5/53) post-intervention, p =1.00. Relapse rates in the intervention period increased (20% vs. 50%) at three-months post-surgery. CONCLUSION: A PETS-initiated NRT program in PAC is feasible and increased preoperative use of NRT and Quitline© with minimal impact on smoking cessation. SO WHAT?: This study has highlighted the importance of implementing a multidisciplinary smoking cessation program in PAC however, larger studies are needed to determine the true impact of the program on smoking cessations.

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OBJECTIVES: To assess the relative frequency and associated factors of disorders of gut-brain interaction (DGBIs) in outpatient gastrointestinal (GI) clinics in young children of Latin America. METHODS: Cross-sectional study in 10 pediatric GI outpatient clinics (private and public) in five countries of Latin America (El Salvador, México, Colombia, Panamá, and Nicaragua). Parents of patients 1 month 4 years of age from outpatient clinics complete/d a diagnostic questionnaire for DGBIs per Rome IV criteria (QPGS-IV, Spanish version). We conducted descriptive analysis, two-sample t-tests and chi-square tests, univariate analyses, and logistic regression to evaluate risk factors. RESULTS: We collected data from 783 children. In total, 34.5% had a DGBI. Overall, functional constipation (FC) was the most common diagnosis (23.4%) in children of all ages (infants, 16.1%, 1-4-years-old, 32.7%). In infants, the second most common DGBI was regurgitation (6.6%) and in 1-4-years-old and cyclic vomiting syndrome (4.1%). The diagnosis of a DGBI was significantly associated with a family history of DGBIs (odds ratio [OR] 2.97, 95% confidence interval [CI] 1.61-5.57, p = 0.0001). Patients who identified as black (OR 2.25, 95% CI 1.28-3.92, p = 0.0021) or mixed race (OR 1.76, 95% CI 1.25-2.48, p = 0.0006) were also significantly associated with a higher likelihood of DGBIs. CONCLUSIONS: DGBIs are a common diagnosis in pediatric GI clinics of Latin America. Overall, FC was the most common DGBI.

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Aim: This study aimed to evaluate the mean post-test probability (PTP) of the Maturity-onset diabetes of the young (MODY) calculator in a multiethnic cohort of patients previously diagnosed with type 1 diabetes (T1DM). Materials and methods: The MODY probability calculator proposed by Shields and colleagues (2012) was applied to 117 patients from a T1DM outpatient clinic at a tertiary hospital in Brazil. Additionally, two exons of the HNF1A gene were sequenced in eight patients who hadn't received insulin treatment within six months after the diagnosis. Results: 17.1 % of patients achieved PTP >10 %; 11.1 % achieved PTP >25 % (and all patients >30 %), and 7.7 % achieved PTP >40 %. Among the patients who were selected for genetic sequencing, 100 % presented PTP >30 %, with 66.6 % achieving PTP >40 % and 41.6 % achieving PTP >75 %. These cutoffs are as suggested for the Brazilian population, according to previous investigations. No mutation was observed in the sequenced exons. Conclusion: Considering that only around 10 % of the evaluated cases achieved PTP >30 %, it is highly probable that the most suitable cutoff to select patients for genetic sequencing in a Brazilian cohort of T1DM is higher than the cutoff used in Caucasian populations.

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Thanks to their guidance and coaching skills, advanced practice nurses (APNs) support teams on a daily basis in improving their practices and developing their reflexivity. Their leadership enables caregivers to question themselves, exchange ideas and think about care from a different angle. Situational analysis sessions provide a space for them to step back, debate and innovate. This meaningful support enabled a newly-qualified IPA to find her place among the teams. Here's a testimonial.

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Background and Aims: Several factors exist regarding the risk for, healing and prevention of pressure ulcers (PUs). A mobile PU team with an individualized holistic approach adapted to the home or outpatient clinic setting could be beneficial for the prevention, and management of PUs. Aims: To describe the mobile PU team's interventions among individuals who had deep PUs and were living at home. Another aim was to describe the patients' perceptions of the quality of the care and having a deep PU. Methods: A quantitative study with a cross-sectional design. At an outpatient clinic, a mobile PU team was established to perform and follow up PU prevention interventions and advanced wound care treatment at home and at the outpatient clinic. All adult patients with existing deep category four PUs remitted to the outpatient clinic were asked to participate, and 16 out of 24 individuals consented. Instruments used for data collection were "Quality from the Patient's Perspective," "Wound-Quality of Life," "Modified Norton Scale," and a study developed protocol for the mobile team's PU interventions. Results: The patients chose home visits 20 times and outpatient clinic visits 89 times. In total, 8-13 interventions per participant were performed by the mobile team. The results show that having PUs affected the participants' perceptions of care and general well-being. The PUs did not heal completely but they did improve, six patients underwent flap surgery. Conclusion: When organizing care regarding patient safety for patients with deep PUs, it is important to consider the patient's perspective and well-being and to involve patients in their care plans. Home care is perhaps not the only way of caring; other aspects, in addition to telemedicine, could be an option.

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BACKGROUND: Environmental bacteria in animal healthcare facilities may constitute a risk for healthcare-associated infections (HAI). Knowledge of the bacterial microflora composition and factors influencing the environmental bacterial load can support tailored interventions to lower the risk for HAI. The aims of this study were to: (1) quantify and identify environmental bacteria in one operating room (OR) and one ultrasound room (UR) in a small animal hospital, (2) compare the bacterial load to threshold values suggested for use in human healthcare facilities, (3) characterise the genetic relationship between selected bacterial species to assess clonal dissemination, and (4) investigate factors associated with bacterial load during surgery. Settle plates were used for passive air sampling and dip slides for surface sampling. Bacteria were identified by Matrix Assisted Laser Desorption-Time Of Flight. Antimicrobial susceptibility was determined by broth microdilution. Single nucleotide polymorphism-analysis was performed to identify genetically related isolates. Linear regression was performed to analyse associations between observed explanatory factors and bacterial load. RESULTS: The bacterial load on settle plates and dip slides were low both in the OR and the UR, most of the samples were below threshold values suggested for use in human healthcare facilities. All settle plates sampled during surgery were below the threshold values suggested for use in human clean surgical procedures. Staphylococcus spp. and Micrococcus spp. were the dominating species. There was no indication of clonal relationship among the sequenced isolates. Bacteria carrying genes conveying resistance to disinfectants were revealed. Air change and compliance with hygiene routines were sufficient in the OR. No other factors possibly associated with the bacterial load were identified. CONCLUSIONS: This study presents a generally low bacterial load in the studied OR and UR, indicating a low risk of transmission of infectious agents from the clinical environment. The results show that it is possible to achieve bacterial loads below threshold values suggested for use in human healthcare facilities in ORs in small animal hospitals and thus posing a reduced risk of HAI. Bacteria carrying genes conveying resistance to disinfectants indicates that resistant bacteria can persist in the clinical environment, with increased risk for HAI.

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In 1998, Fried and Walston introduced the Cycle of Frailty (CF) as a foundational concept for defining the physical frailty phenotype (FP). While the FP has been extensively validated, the CF hypothesis lacks equivalent support. This study aimed to internally validate the CF using structural equation modeling (SEM) in a clinical dataset of adults aged 50 or older attending an outpatient falls clinic. Measures included: age, morbidity, nutrition, sarcopenia by bioelectrical impedance, VO2max, handgrip strength, basal metabolic rate (BMR), 5-times chair stand test (5CST), physical activity, and total energy expenditure (TEE). The SEM, incorporating CF hypothesized causal pathways, was tested using IBM® SPSS® Amos 27.0.0 (maximum likelihood method) with a sample of 102 adults (mean age 69.8 years, 58.8% women). Overall, the SEM was supported by the data (χ2 = 44.4, df = 37, p = 0.189), with significant (p < 0.05) regression weights for morbidity→sarcopenia, age→sarcopenia, sarcopenia→VO2max, sarcopenia→handgrip strength, handgrip strength→5CST, physical activity→TEE, TEE→nutrition, and BMR→TEE. However, nutrition→sarcopenia, sarcopenia→BMR, VO2max→5CST, and 5CST→physical activity were not significant. Although the SEM was limited by inclusion of surrogate CF measures (e.g., 5CST instead of gait speed, VO2max based on age-predicted maximal/resting heart rate), it provided some internal support for the CF hypothesis.