Pre-frailty factors in community-dwelling 40–75 year olds: opportunities for successful ageing

Abstract

Background: There is little known about pre-frailty attributes or when changes which contribute to frailty might be detectable and amenable to change. This study explores pre-frailty and frailty in independent community-dwelling adults aged 40-75 years. Methods: Participants were recruited through local council networks, a national bank and one university in Adelaide, Australia. Fried frailty phenotype scores were calculated from measures of unintentional weight loss, exhaustion, low physical activity levels, poor hand grip strength and slow walking speed. Participants were identified as not frail (no phenotypes), prefrail (one or two phenotypes) or frail (three or more phenotypes). Factor analysis was applied to binary forms of 25 published frailty measures Differences were tested in mean factor scores between the three Fried frailty phenotypes and ROC curves estimated predictive capacity of factors. Results: Of 656 participants (67% female; mean age 59.9 years, SD 10.6) 59.2% were classified as not frail, 39.0% pre-frail and 1.8% frail. There were no gender or age differences. Seven frailty factors were identified, incorporating all 25 frailty measures. Factors 1 and 7 significantly predicted progression from not-frail to pre-frail (Factor 1 AUC 0.64 (95%CI 0.60-0.68, combined dynamic trunk stability and lower limb functional strength, balance, foot sensation, hearing, lean muscle mass and low BMI; Factor 7 AUC 0.55 (95%CI 0.52-0.59) comprising continence and nutrition. Factors 3 and 4 significantly predicted progression from pre-frail to frail (Factor 3 AUC 0.65 (95% CI 0.59-0.70)), combining living alone, sleep quality, depression and anxiety, and lung function; Factor 4 AUC 0.60 (95%CI 0.54-0.66) comprising perceived exertion on exercise, and falls history. Conclusions: This research identified pre-frailty and frailty states in people aged in their 40s and 50s. Pre-frailty in body systems performance can be detected by a range of mutable measures, and interventions to prevent progression to frailty could be commenced from the fourth decade of life.

Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults

“…It is worth mentioning that although the physical tests used in this study are simple, they assess habitual daily functions, which in turn are indicative of many underlying physiological processes ( Jones et al, 1999 ; Ferguson-Stegall et al, 2017 ). The improvements observed in cardiorespiratory fitness, resistance of the lower limb muscle strength, functional mobility, and gait speed in dual-tasks contribute to the functional independence of older adults and are associated with quality of life ( Gordon et al, 2020 ; Yang et al, 2020 ).…”

Correlation between Sleep Quality and Frailty Status among Middle-Aged and Older Taiwanese People: A Community-Based, Cross-Sectional Study

“…Furthermore, prefrailty status fulfilling only one or two criteria of frailty also increased the risk of frailty [ 11 ]. One study showed some factors including high psychological distress, living alone, having health worries, and poor sleep quality; stair climbing, appetite, hydration; continence, and total food intake might be the predictive capacities for prefrailty to frailty [ 39 ]. With increasing age, there is also a decline in physical activity associated with decreases in exercise tolerance, which would lead to an increasing risk of frailty [ 31 ].…”

Validation of replacement questions for slowness and weakness to assess the Fried Phenotype: a cross-sectional study

“…Consequently, the replacement of these performance-based measures by self-report questions may be helpful in the development of an easy to apply frailty-screening tool, which may enable to screen large populations [6,10]. Although the two performance-based criteria (slowness and weakness) of the Frailty Phenotype were already replaced by questions in a few earlier studies (e.g., Santos-Eggimann and colleagues 2009, Gordon and colleagues 2020) [13,14], still little is known about which questions (or set of questions) are most valid to substitute the performance-based measures [10]. In most of the studies in which self-report questions were used, the validity of these questions was not tested, or at least not reported, while these modifications may have an important impact on its classification and predictive ability [10,15].…”