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

Abstract

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.

Outcome of older adults at risk of frailty

“…24 A prospective study by Zhang et al identified the frailer population was at risk of disability and falls in the future. 25 A similar association was also observed in the EPIDOS study in community-dwelling older adults using the phenotype model 26 and in the hospitalized patients by Liang et al…”

What Is Frailty? Perspectives from Chinese Clinicians and Older Immigrants in New Zealand

“…Our third theme considered psychological and social health. Depression and mental health problems was found to be associated with frailty in older Chinese (Chang et al 2011 ; Ma et al 2020 ; Tian et al 2018 ; Ye et al 2018 ; Zhang et al, 2020b ) and was an important contributor of frailty in the Singapore Longitudinal Ageing studies (Ng et al 2014 ). It has been suggested people with depression may be more pessimistic about the progression of their health problems, perceive less control over their objective health and foresees a poorer prognosis of their current health complaints (Hong et al 2004 , Taylor and Brown, 1988 ).…”

Assessing the Costs of Home Palliative Care in Italy: Results for a Demetra Multicentre Study

“…Among others, frailty has already been studied as a measure able to predict palliative home care intensity [ 27 ]. Similarly, an association between frailty and disability has been observed [ 28 ], with the former showing extreme susceptibility and heightened vulnerability to adverse health outcomes, and the latter showing actual disabilities in carrying out daily activities. Together, those conditions, when severe, seem to require a sharp intensification of home palliative care visits and presumably lead to an increase in burden for caregivers.…”