Correlation between Frailty Level and Adverse Health-related Outcomes of Community-Dwelling Elderly, One Year Retrospective Study

Abstract

BackgroundFrailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization, falls, cognitive decline and disability between robust, prefrail and frail elderly in one year.Methods110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008 were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression, mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago.ResultsAmong total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54 (49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease, depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P < 0.005).ConclusionThe frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.

Evaluation of frailty, functional capacity and quality of life of the elderly in geriatric outpatient clinic of a university hospital

“…Although literature has identified a relationship between a history of falls and frailty, 33 this was not observed in this sample, as there was no difference between the F, PF and NF groups. Moreira and Lourenço 20 argued that only a history of three or more falls, which define the elderly individual as a faller, is directly linked to frailty, which may explain the lack of an association here, as in addition to the rate of falls being low, 80% of these elderly individuals had a history of only one fall.…”

Quedas: conceitos, frequências e aplicações à assistência ao idoso. Revisão da literatura

“…1 Em função de sua natureza multifatorial, sua frequência e suas consequências, as quedas constituem uma das grandes síndromes geriátricas e um dos maiores problemas de saúde pública. [2][3][4] Além de estarem relacionadas a maior morbidade e mortalidade na velhice, 5 associam-se a restrição na mobilidade, fraturas, depressão, incapacidade funcional, perda da independência e autonomia, institucionalização e declínio da qualidade de vida, bem como têm gerado implicações socioeconômicas e sobrecarga para os sistemas de saúde. 6,7 Para a American Geriatrics Society (AGS) e a British Geriatrics Society (BGS), 6 as quedas são definidas como um contato não intencional com a superfície de apoio, resultante da mudança de posição do indivíduo para um nível inferior à sua posição inicial, sem que tenha havido fator intrínseco determinante ou acidente inevitável e sem perda de consciência.…”

Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International Consensus Group

“…falls, disability, hospitalization, mortality) (25)(26)(27)(28), and has further been associated with biological abnormalities (e.g. biomarkers of inflammation) regardless of the definition used to assess frailty (29).…”