Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study

Abstract

To investigate frailty state transitions in a cohort of older Italian adults to identify factors exacerbating or improving frailty conditions. Design: Population-based longitudinal study with mean follow-up of 4.4 years. Setting: Community. Participants: Individuals enrolled in the Progetto Veneto Anziani (Pro.V.A.) (N = 2,925; n = 1,179 male, n = 1,746 female; mean age 74.4 ± 7.3). Measurements: Frailty was identified at baseline and follow-up based on the presence of at least three Fried criteria; prefrailty was defined as the presence of one or two Fried criteria. Anthropometric, socioeconomic, and clinical characteristics were assessed at baseline in a personal interview and clinical examination using validated scales and medical history. During the study period, 1,114 (38.1%) subjects retained their baseline frailty status, 1,066 (36.4%) had a transition in frailty status, and the remainder of the sample died. Older age, female sex, obesity, cardiovascular disease, osteoarthritis, smoking, loss of vision, low levels of self-sufficiency and physical performance, cognitive impairment, hypovitaminosis D, hyperuricemia, and polypharmacy were associated with increasing frailty and greater mortality. Conversely, overweight, low to moderate drinking, high educational level, and living alone were associated with decreasing frailty. Frailty was confirmed as a dynamic syndrome, with socioeconomic and clinical factors that could be targets of preventive actions influencing transitions to better or worse frailty status

Frailty state transitions and associated factors in South Australian older adults

“…Gradual worsening to an adjacent frailty state has been identified as a common feature of frailty across a number of studies that have used a FP method. 9,10,24 The present findings on the association between obesity and the development of frailty are consistent with those of others who identified that obesity and overweight increased the risk of non-frail individuals transitioning to a worse frailty state. 11 Despite worsening of frailty level being the most common transition in this cohort, interventions exist that might prevent worsening.…”

“…7-10 A pattern of gradual decline has also been identified in a study that examined change in mean FI score. 10,22,25 The mechanisms by which obesity has a potential impact on frailty status include inflammatory dysregulation and sarcopenic obesity, where a mismatch exists between fat mass and muscle mass. 1,23 The worsening of non-frail individuals was significantly associated with the presence of multimorbidity for both measures, and with obesity and living with others for the FI.…”

“…[1][2][3][4] Frailty is common among older adults, and the prevalence has been measured at 14% using the frailty phenotype (FP) and 24% using the frailty index (FI), 2 which are the two main approaches to the measurement of frailty. [7][8][9][10][11] Frailty is a dynamic process where improvement is possible, with rates of improvement in frailty status ranging from 6% to 25%. 5,6 There is growing interest in how frailty changes over time, and the factors that are associated with early versus late stage frailty for possible intervention.…”

Lower Physical Performance in Colder Seasons and Colder Houses: Evidence from a Field Study on Older People Living in the Community

“…Because the average insulation is low in Japan, we could not find a larger warm sample. With this sample size, we were not able to evaluate other relevant factors that could influence physical performance, such as sex, age, chronic illness, and obesity, all of which are related to frailty [37]. Although we were not able to conduct a multivariate analysis including these factors due to our small sample size, we did confirm that there were no differences in individual attributes between people living in cold houses and warm houses.…”

Association between serum vitamin B12 levels and frailty in older adults

“…In the United Kingdom, twins were evaluated for frailty, and it was determined that even between twins, lower education level increased predisposition to frailty [15, 16]. Predisposition to frailty may be related to influence of education level on bad habits [17], lower income level, decreased self-care, and aggravated cognitive deficiency.…”