Frailty state among Indonesian elderly: prevalence, associated factors, and frailty state transition

Abstract

Background Information about frailty status and its transition is important to inform clinical decisions. Predicting frailty transition is beneficial for its prevention. While Indonesia is the 4th largest geriatric population in Asia, data about frailty transition is limited. This study aimed to obtain data on prevalence of frailty, its risk factors, frailty state transition and its prognostic factors, as well as to develop prognostic score for frailty state transition. Methods Multicenter study on subjects aged ≥60 years old was done to obtain the prevalence of frailty status and to identify risk factors of frailty. Prospective cohort over 12 months was done to obtain data on frailty state transition. Multiple logistic regression analysis was performed to identify its prognostic factors from several clinical data, which then were utilized to develop prognostic score for frailty state worsening. Results Cross-sectional data from 448 subjects showed that 25.2% of the subjects were frail based on Frailty index-40 items. Risk factors of frailty were age (OR 2.72; 95% CI 1.58–4.76), functional status (OR 2.89; 95% CI 1.79–4.67), and nutritional status (OR 3.75; 95% CI 2.29–6.13). Data from the 162 subjects who completed the cohort showed 27.2% of the cohort had frailty state worsening. Prognostic factors for frailty state worsening were being 70 years or older (OR 3.9; 95% CI 1.2–12.3, p < 0.05), negative QoL, i.e., fair and poor QoL (OR 2.5; 95% CI 1.1–5.9, p < 0.05), and slow gait speed (OR 2.8; 95% CI 1.3–6.4, p < 0.05). The internal validation of the prognostic score consisted of those three variables showed good performance. Conclusion The prevalence of frailty in this study among Indonesian elderly in outpatient setting was 25.2%. The risk factors of frailty were age, functional status and nutritional status. The prognostic factors for frailty state worsening were being 70 years old or older, negative QoL (fair or poor quality of life), and slow gait speed. A prognostic score to predict frailty state worsening in 12 months had been developed.

Prevalence and Associated Factors of Frailty in Community-Dwelling Older Adults in Indonesia, 2014–2015

“…The prevalence of frailty was 8.1%, which is similar to population-based studies in the region, e.g., China (7.0%) [9], Malaysia (9.4%) [11], and Singapore (5.7%) [12], but lower than the global prevalence in low-and middle-income countries (17.4%) [7]. A higher prevalence of frailty was found among geriatric clinic patients in Indonesia (25.2%) [8], which may be explained by the differences in the recruitment setting; a higher prevalence of frailty is expected in geriatric clinic patients at referral hospitals than in a community setting. Physical inactivity was the most common frailty component in this study, which compares with a study in Germany [14] and demonstrates the importance of the promotion of physical activity in this population.…”

“…The prevalence of frailty in individuals 60 years and older in low-and middle-income countries was 17.4% and pre-frailty 49.3% [7]. There is scant information on frailty prevalence and correlates in lower-middle-income countries, such as Indonesia [8]. In a study of 448 geriatric clinic patients (60 years and older) in Indonesia, 25.2% were frail [8].…”

“…There is scant information on frailty prevalence and correlates in lower-middle-income countries, such as Indonesia [8]. In a study of 448 geriatric clinic patients (60 years and older) in Indonesia, 25.2% were frail [8]. In population-based studies in countries in the East and Southeast Asian region, the prevalence of frailty was 7.0% in China (60 years or older) [9], 20% in India (50 years and older) [10], 9.4% in Malaysia (60 years and older) [11], and 5.7% in Singapore (60 years and older) [12].…”

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

“…Several studies have reported on the natural transitions in frailty status and their factors, which are mostly associations with sociodemographic factors and health status [17][18][19][20][21][22][23][24]. For instance, those who are older, [17,19,23,24] have fewer years of education, [16] have diabetes and previous stroke, [17] have poor functional performance, [19,21,24] and have cognitive impairment [22] are associated with frailty worsening. These findings are helpful for health practitioners to recognize susceptible individuals, though they seem inadequate to provide health promotional planning for community aged populations.…”

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

“…In the Singapore Longitudinal Ageing Study 2 on 1297 older community-dwellers, older age was one of the significant predictors for frailty transition (defined by the frailty phenotype) after 3-5 years [12]. In another study in Indonesia, older age, low quality of life, and slow gait speed were prognostic factors for frailty transition (defined by the Frailty Index) after 12 months [13]. In a study on 696 older people in Australia, chronological age and multimorbidity were associated with frailty transition during 4.5 years of follow up (with frailty defined by the frailty phenotype and by the Frailty Index) [14].…”