Association between frailty and incident risk of disability in community-dwelling elder people: evidence from a meta-analysis

Liu, H.X.; Ding, Guoyong; Yu, Wen-Ruey; Liu, T.F.; Yan, Aoshuang; Chen, H.Y.; Zhang, A.H.

doi:10.1016/j.puhe.2019.06.010

Cited by 63 publications

(56 citation statements)

References 39 publications

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“…Our finding that baseline frailty was strongly associated with incident disability and worsening disability coincides with results from previous studies [6,8,18,19]. For example, using the Survey of Health, Aging and Retirement in Europe (SHARE), Macklai et al [8] showed that at a two-year follow up, frail individuals were at increased risk for developing ADL and IADL difficulties and experiencing an increase in the number of ADL difficulties.…”

Section: Discussionsupporting

confidence: 89%

“…For example, using the Survey of Health, Aging and Retirement in Europe (SHARE), Macklai et al [8] showed that at a two-year follow up, frail individuals were at increased risk for developing ADL and IADL difficulties and experiencing an increase in the number of ADL difficulties. Additional solid evidence was provided in two systematic reviews showing that frail people were more likely to have incident disability [18,19] and worsening disability [19]. The present study extended previous research by using national representative data from China, which has the largest population of elderly people in the world.…”

Section: Discussionsupporting

confidence: 65%

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Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

et al. 2020

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Background Frailty, which is defined as aging-related multisystem impairments, can lead to adverse health outcomes. However, evidence for such a connection in Chinese older adults remains lacking. This study examined the association between frailty and future falls and disability among community-dwelling Chinese older adults. Methods Data were obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. Participants were aged 60 years and above at baseline in 2011 and completed the follow-up survey in 2015. Outcome measures were future falls, incident disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and worsening performance of ADLs and IADLs. A multivariate logistic regression was conducted to examine the association between frailty phenotype and falls, incident disability, and worsening disability during a four-year period. Results We found that frail participants were at increased risk at follow-up for: falls (OR 1.54, 95% CI, 1.14–2.08); developing new ADL difficulties (OR 4.10, 95% CI, 2.79–6.03) and IADL difficulties (OR 3.06, 95% CI, 2.03–4.61); and worsening ADLs performance (OR 2.27, 95% CI, 1.27–4.06), after adjusting for potential confounders. Prefrailty was also significantly associated with future falls, incident disability in ADLs and IADLs, but with a lower magnitude of effect. Conclusions Frailty phenotype is an independent predictor of future falls, incident disability, and worsening performance in ADLs among Chinese older adults. The association suggests the need to pay special attention in caring for frail and prefrail elders and improving individuals’ frailty status.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 65%

Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

et al. 2020

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“…This finding is consistent with previous studies showing that frailty is a risk factor for dementia [35]. The uniqueness of this study is the fact that the competing risk of death was considered when exploring the influence of frailty on incident dementia in China [36], which can result in accurate HRs, despite a limitation to using those experiences directly because of the difference between China and other Western countries. Although the results of the three definitions differ slightly, frailty can generally increase the hazard of incident dementia.…”

Section: Discussionsupporting

confidence: 89%

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

Huang

Liu

et al. 2020

BMC Geriatr

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Background: The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence. Methods: A five-year prospective cohort study was carried out in 2022 participants aged 65 years and over in urban and rural sites in Beijing, China. The participants were interviewed by trained community primary health care workers from 2004 to 2009. Frailty was defined using modified Fried frailty phenotype, physical frailty definition, and multidimensional frailty definition. Dementia was diagnosed using the 10/66 dementia criterion for calculating cumulative incidence. Both competing risk regression models and Cox proportional hazards models were applied to examine the associations between frailty at baseline and five-year cumulative incidence of dementia. Results: At the end of follow-up the five-year cumulative incidence rates of dementia with frailty and without frailty defined by the modified Fried frailty were 21.0% and 9.6%, those defined by the physical frailty were 19.9% and 9.0%, and those defined by the multidimensional frailty were 22.8% and 8.9%, respectively. Compared with non-frail participants, frail people had a higher risk of incident dementia using multidimensional frailty definition after adjusting covariates based on competing risk regression model (HR = 1.47, 95% CI 1.01~2.17) and Cox proportional hazards model (HR = 1.56, 95% CI 1.07~2.26). The association between frailty and incident dementia was statistically significant in participants in the upper three quartiles of age (aged 68 years and over) using the multidimensional frailty definition based on the competing risk regression model (HR = 1.61, 95% CI 1.06~2.43) and Cox proportional hazard model (HR = 1.76, 95% CI 1.19~2.61).

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“…With the growing aging population worldwide, 1 frailty is increasingly an important issue because frailty is closely related to older age. 2 Many studies have shown that frail older people have an increased risk of disability, 3 hospitalization, 4 institutionalization, 5 lower quality of life, 6 and premature death. 7 The importance of paying attention to frailty is hardly disputed by research and practice; however, opinions differ widely about what qualifies as frailty.…”

Section: Introductionmentioning

confidence: 99%

<p>The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity</p>

Gobbens¹,

Boersma²,

Uchmanowicz³

et al. 2020

CIA

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Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls. Methods: The validity of the TFI was determined in a sample of 180 Dutch communitydwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later. Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) >0.8. In most cases, using the cutoff point 5 for total frailty ensured the best values for sensitivity and specificity. Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.

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Association between frailty and incident risk of disability in community-dwelling elder people: evidence from a meta-analysis

Cited by 63 publications

References 39 publications

Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

Frailty as a predictor of future falls and disability: a four-year follow-up study of Chinese older adults

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

<p>The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity</p>

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