An interRAI‐derived frailty index is associated with prior hospitalisations in older adults residing in retirement villages

Bloomfield, Katherine; Wu, Zhenqiang; Tatton, Annie; Calvert, Cheryl; Peel, Nancye M.; Hubbard, Ruth E.; Jamieson, Hamish A.; Hikaka, Joanna; Boyd, Michal; Bramley, Dale; Connolly, Martin J.

doi:10.1111/ajag.12863

Cited by 7 publications

(15 citation statements)

References 20 publications

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“…In comparison, a recent analysis using a modified Fried Frailty Phenotype with a pooled cohort of 8804 community‐dwelling Australian adults aged ≥65 years determined that 21% of participants were frail, while a further 48% were prefrail 11 . The prevalence rate of retirement village residents who were classified as robust was similar to that of those classified as ‘fit’ (36%) in retirement villages in New Zealand 18 using a frailty index derived from a cumulative deficit model and almost identical to the proportion of older people identified as being not frail or prefrail in the comparable community‐dwelling Australian (31%) 17 . However, the prevalence rate of frailty was consistently higher in retirement village residents than the comparable community‐dwelling Australians for all age groupings.…”

Section: Discussionmentioning

confidence: 91%

“…The results were not obtained from a random sample of retirement village residents in regional Victoria; consequently, the findings might not be representative of broader populations of interest including metropolitan locations. Furthermore, the results were drawn from a sample who were mostly European and had English as their preferred language, which is similar to demographic data obtained from retirement villages in New Zealand, 18 but makes it difficult to generalise to retirement villages that might include different ethnic backgrounds. Although validated, the tools used to define frailty and mobility disability relied on self‐report, which might have caused misclassification in some cases.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of frailty and mobility disability in older people living in retirement villages

2021

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Objective To determine the prevalence rates of frail, prefrail, robust and mobility disabled older adults living in retirement villages within regional Victoria, Australia. Methods This cross‐sectional, observational study invited residents of retirement villages to complete the self‐report questionnaires Fried Frailty Phenotype and Frail Non‐Disabled screening tool to classify respondents as frail, prefrail, robust and/or mobility disabled. Results From 212 respondents, prevalence rates of frail and prefrail status were 34% and 35%, respectively. A fifth (20%) of residents were mobility disabled. The prevalence of residents classified as frail or prefrail (ie, not robust) was higher in women (74%) than in men (58%). Classification as not robust increased with increasing age. Conclusions This study is the first to estimate prevalence rates of frailty and mobility disability in retirement village residents in regional Australia. Findings from this study have potential to inform the development of facilities and programs to support people living in this setting.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Prevalence of frailty and mobility disability in older people living in retirement villages

2021

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“…interRAI- derived FI data was available for 577 (FI items obtained from interRAI-HC in 12 subjects). Baseline characteristics and frailty have been reported elsewhere [ 9 ] and summarised in Table 1 . Mean (SD) age was 81 (7) years, 419 (73%) were female, and 557 (97%) were European, 8 (1%) Asian, 7 (1%) Māori, 1 (<1%) Pasifika, and 4 other (<1%).…”

Section: Resultsmentioning

confidence: 99%

“…InterRAI-CHA items were used to generate an FI based on the cumulative deficit model [ 9 ]. The FI had 57 variables, with most scored in a binary manner (absent 0, present 1), and ordinal or continuous variables scored between 0 and 1 (e.g.…”

Section: Methodsmentioning

confidence: 99%

“…The interRAI-Community Health Assessment (CHA) is one of several interRAI tools designed to assess health, functional and social needs in community-dwelling older adults [ 8 ]. We recently developed a frailty index (FI) from interRAI-CHA and found it was associated with healthcare utilization in the 12 months prior to assessment in older adults residing in RVs [ 9 ]. Here we report the ability of this FI tool to prospectively predict healthcare outcomes (acute hospitalization, LTC entry and mortality).…”

Section: Introductionmentioning

confidence: 99%

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An interRAI derived frailty index predicts acute hospitalizations in older adults residing in retirement villages: A prospective cohort study

Bloomfield

Tatton

et al. 2022

PLoS ONE

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Objectives The development of frailty tools from electronically recorded healthcare data allows frailty assessments to be routinely generated, potentially beneficial for individuals and healthcare providers. We wished to assess the predictive validity of a frailty index (FI) derived from interRAI Community Health Assessment (CHA) for outcomes in older adults residing in retirement villages (RVs), elsewhere called continuing care retirement communities. Design Prospective cohort study. Setting and participants 34 RVs across two district health boards in Auckland, Aotearoa New Zealand (NZ). 577 participants, mean age 81 years; 419 (73%) female; 410 (71%) NZ European, 147 (25%) other European, 8 Asian (1%), 7 Māori (1%), 1 Pasifika (<1%), 4 other (<1%). Methods interRAI-CHA FI tool was used to stratify participants into fit (0–0.12), mild (>0.12–0.24), moderate (>0.24–0.36) and severe (>0.36) frail groups at baseline (the latter two grouped due to low numbers of severely frail). Primary outcome was acute hospitalization; secondary outcomes included long-term care (LTC) entry and mortality. The relationship between frailty and outcomes were explored with multivariable Cox regression, estimating hazard ratios (HRs) and 95% confidence intervals (95%CIs). Results Over mean follow-up of 2.5 years, 33% (69/209) of fit, 58% (152/260) mildly frail and 79% (85/108) moderate-severely frail participants at baseline had at least one acute hospitalization. Compared to the fit group, significantly increased risk of acute hospitalization were identified in mildly frail (adjusted HR = 1.88, 95%CI = 1.41–2.51, p<0.001) and moderate-severely frail (adjusted HR = 3.52, 95%CI = 2.53–4.90, p<0.001) groups. Similar increased risk in moderate-severely frail participants was seen in LTC entry (adjusted HR = 5.60 95%CI = 2.47–12.72, p<0.001) and mortality (adjusted HR = 5.06, 95%CI = 1.71–15.02, p = 0.003). Conclusions and implications The FI derived from interRAI-CHA has robust predictive validity for acute hospitalization, LTC entry and mortality. This adds to the growing literature of use of interRAI tools in this way and may assist healthcare providers with rapid identification of frailty.

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Australian retirement village residents: wellbeing profiles and factors associated with low wellbeing

Joe¹,

Dickins

Cyarto

et al. 2023

Ageing and Society

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The characteristics of Australian retirement village residents, an under-researched population, are not well understood. Knowledge of their wellbeing and modifiable factors associated with low wellbeing would aid in the introduction of health promotion measures and supports to facilitate healthy ageing-in-place. A novel approach utilising latent class analysis (LCA), a statistical method not previously employed to study this population, was undertaken to analyse cross-sectional survey data from 871 participants aged ≥65 years from retirement villages in Queensland, Australia. LCA identified latent, i.e. unobserved, underlying and often difficult to measure, groups within this population based on the responses of individuals to multiple observed variables. Survey participants were divided into groups, each with a distinct profile associated with a wellbeing state, as determined by responses to questions about physical health, unplanned hospitalisations, cognitive health and social connectedness. Multinomial logistic regression explored the relationship between modifiable health and lifestyle characteristics and membership of a particular wellbeing group. The median age of participants was 82 years (interquartile range = 76–88). While 69.0 per cent reported good to excellent health, polypharmacy was evident with 45.6 per cent of participants taking five or more prescription medications. In the previous 12 months, 33.3 per cent had experienced one or more falls and 30.6 per cent an unplanned hospitalisation. Distinct profiles were identified for three wellbeing groups: high (57.7% of participants), moderate (20.6%) and low wellbeing (21.7%). Injurious falls, limited ability to prepare meals and debilitating pain were associated with the moderate and low wellbeing groups. Physical activity significantly lowered the probability of a retirement village resident being in the low wellbeing group. Our findings highlight falls prevention, maintaining adequate nutrition, pain management and regular physical activity as actions that may optimise wellbeing, mitigate functional decline and support the independence of retirement village residents into later years of life.

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An interRAI‐derived frailty index is associated with prior hospitalisations in older adults residing in retirement villages

Cited by 7 publications

References 20 publications

Prevalence of frailty and mobility disability in older people living in retirement villages

Prevalence of frailty and mobility disability in older people living in retirement villages

An interRAI derived frailty index predicts acute hospitalizations in older adults residing in retirement villages: A prospective cohort study

Australian retirement village residents: wellbeing profiles and factors associated with low wellbeing

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