Frailty as a Predictor of Hospitalization and Low Quality of Life in Geriatric Patients at an Internal Medicine Outpatient Clinic: A Cross-Sectional Study

Abstract

Frailty is an aging-associated state that increases patients’ vulnerability to disease, and can lead to various adverse outcomes. It is classified as either physical frailty alone or physical frailty in combination with cognitive impairment (cognitive frailty). There are currently limited data available regarding the prevalence and adverse outcomes of frailty in Thailand. This was a cross-sectional study aimed at determining the prevalence of physical and cognitive frailty and their effects on hospitalization and quality of life. Participants were older patients who attended an internal medicine outpatient clinic. Frailty was diagnosed using the Thai Frailty Index. The Thai version of the MoCA was used to evaluate cognitive status. Univariate and multivariate analyses were performed to compare adverse outcomes in terms of poor quality of life and history of admission to hospital between patients with frailty and non-frail patients, and among patients with physical frailty, cognitive frailty, cognitive impairment, and robust (non-frail and non-cognitively impaired) patients. We enrolled 198 participants. The prevalence of physical and cognitive frailty was 28.78% and 20.70%, respectively. When compared with non-frail patients, frailty was associated with hospitalization (adjusted OR 3.01, p = 0.002) but was not significantly related to quality of life (adjusted OR = 1.98, p = 0.09). However, physical and cognitive frailty were associated with fair quality of life when compared with normal patients (adjusted OR = 4.34, p = 0.04 and adjusted OR = 4.28, p = 0.03, respectively). The prevalence of frailty—particularly cognitive frailty—was high. Frailty was associated with adverse outcomes in terms of hospitalization and quality of life.

The Relationship Between Rehabilitation and Frailty in Advanced Heart or Lung Disease

“…32 Moreover, increased frailty is associated with an increased risk of morbidity, mortality, and hospitalization (or nursing home admission). 9,33,34 Nonetheless, it is noteworthy that inpatients who were participating in rehabilitation before their hospital admission had significantly lower frailty scores and lower prevalence of frailty compared with inpatients who were not.…”

Cognitive status and low sun exposure as frailty major risk factor among older people in a rural area of East Java, Indonesia: A cross‐sectional study

“…3 Frailty is a dynamic multidimensional geriatric syndrome with increased vulnerability to homeostasis after a stressor event and is a consequence of the cumulative decline in many physiological systems. 3,4 Over the past decade, interest in frailty has substantially grown among geriatric researchers because of its predictive mortality, 5 urgent hospitalization, 6 injurious falls, disability, 7 postoperative complications, 8 caregiver burden, 9 and decreased quality of life. 10 Since frailty is a reversible condition, early identification can help (frail) older people remain independent and self-reliant for as long as possible.…”