Mexican Americans and Frailty: Findings From the Hispanic Established Populations Epidemiologic Studies of the Elderly

Abstract

Objectives-We examined frailty, particularly how diabetes and obesity impact disability and morbidity in Mexican American older adults.Methods-We studied the trajectory of frailty over 10 years in 2,049 Mexican Americans participating in the Hispanic Established Populations Epidemiologic Studies of the Elderly. A frailty index based on weight loss, exhaustion, grip strength, walking speed, and physical activity was computed and data were collected on sociodemographic and health status, comorbidities and performance-based functional measures.Results-The sample was 58% female with a mean age of 74.43 (sd = 6.04) at baseline. Analyses at 10 year follow-up revealed 75% of the surviving sample (N = 777) were classified as pre-frail or frail compared to 55% at baseline. 84% of persons identified as frail at baseline died by the end of follow-up. Baseline age, diabetes, arthritis, smoking status, body mass index, cognition, negative affect, and number of comorbid conditions were predictors of frailty at follow-up (R 2 = 0.29, p <. 05).Conclusions-Research is needed to reduce the number of Mexican American older adults who become frail and transition to disability and loss of independence. MeSH keywordsFrail elderly; Mexican Americans; health status; activities of daily living CONTRIBUTORSKenneth Ottenbacher was responsible for conceptualization of the longitudinal frailty component of the study and development of hypotheses. He contributed to writing and reviewing all sections of the paper and interpretation of data. James Graham assisted in data analysis, interpretation and contributed to writing discussion. Soham Al Snih conducted data analyses and prepared drafts of the results section. Mukaila Raji contributed to identification of covariates, interpretation of analyses, and prepared the methods section. Rafael Samper-Ternent contributed to management and analysis of the 2006 data and coding of variables. He also participated in writing results section. Glenn Ostir contributed to interpretation of data from all behavioral and psychological measures and helped prepare the methods section. He reviewed all aspects of the paper. Kyriakos Markides was responsible for overall design of the larger EPESE study and identification of variables and analyses of 1995/96 data. He also contributed to introduction, discussion and interpretation of longitudinal trends. HUMAN PARTICIPANT PROTECTION

The prevalence of frailty syndrome in an older population from Spain. The Toledo study for healthy aging

“…Our findings are similar to the results from previous studies suggesting that frailty is strongly associated to disability (table 3), but they are not the same because 68% and 87% of the subjects who had some dependency to basic and instrumental activities of daily living were not frail (3,4,8,27,28). As in previous studies, frailty was strongly associated with comorbidity, especially symptomatic cardiovascular diseases (29) and cognitive impairment.…”

Relationship between lower-limb muscle strength and frailty among elderly people

“…The results from the studies by Fried et al, 8 Woods et al, 28 Ávila-Funes et al 29 and Ottenbacher et al 30 demonstrated significant correlations (P < 0.05) between female sex, advanced age and frailty. Ottenbacher et al 30 only found an association between female sex and frailty, while Purser et al 9 also found that the five-times sit-tostand test was a strong predictor of frailty. These findings show the relevance and applicability of this study, which makes it simpler to identify frailty risk groups through an easily applied lower-limb muscle strength test.…”

Frailty in elderly diabetes patients

“…When screened for in a population of people with DM, the prevalence of frailty also varied and was reported to be between 5-48% [31]. Several studies have shown that older DM patients were more likely to be frail than their non-DM counterparts [19][20][21][32][33][34][35]. These studies also reported that DM patients with frailty had a higher mortality rate than non-frail DM patients, with the presence of frailty an independent risk factor for mortality.…”