Prevalence and determinants of physical frailty among people living in residential aged care facilities: a large-scale retrospective audit

Abstract

Background Physical frailty is associated with increased risk of falls, hospitalisation and mortality. There is a dearth of information on physical frailty of older adults living in residential aged care. This study aimed to describe physical frailty in aged care residents and investigate possible determinants of frailty. Method A retrospective audit of resident records was undertaken across 14 residential aged care facilities. Data were extracted on all consenting residents who had completed measures relating to frailty (Short Physical Performance Battery SPPB; grip strength). All data of the first record of measures were extracted, resident characteristics, and the time from admission to assessment. Summary statistics were completed. Differences between sub-groups were explored (Mann-Whitney U, Kruskall-Wallis Ranked tests). Associations between variables were explored with Chi-squared and Pearson correlations. Determinants of physical frailty were determined with linear regression analyses. Alpha (2-sided) was 0.05. Results Data were extracted for 1241 residents (67% female), with a mean age of 86.0 (7.6) years. Males had a significantly lower time from admission to assessment of frailty (p ≤ 0.001). The average SPPB score was 4.1 (3.3), 75% of residents were frail and 19% pre-frail. Bivariate analyses indicated no significant relationships between grip strength and SPPB score, but significant differences for grip strength, where males were significantly stronger (males 20.2 ± 8.3 kg; females 12.4 ± 5.4 kg; p ≤ 0.001). There was a significant positive relationship between SPPB total score and grip strength, gender (p ≤ 0.001), and marital status (p = 0.049) and a negative relationship between time from admission to assessment and SPPB total score (p ≤ 0.001). There were significant negative relationships between gender (p ≤ 0.001) and age (p ≤ 0.001), and time from admission to assessment (p ≤ 0.001) with grip strength. Conclusion Older adults living in residential aged care have a high level of physical frailty which may lead to increased risk of adverse outcomes. Time in the residential aged care setting and age appear to predict physical frailty. There is a need for a consistent battery of measures to continually monitor frailty and programs to address the high levels of frailty in residential aged care.

Excess winter mortality in Finland, 1971–2019: a register-based study on long-term trends and effect modification by sociodemographic characteristics and pre-existing health conditions

“…However, they are likely to spend more time indoors within confined environments, which may increase the spread of infections. 39 Furthermore, the prevalence of frailty is considerably high among older adults living in residential care, 40 indicating their increased risk of mortality and vulnerability to external stressors. 41 …”

Correlation of frailty assessment metrics in one-year follow-up of aged care residents: a sub-study of a randomised controlled trial

“…Studies of community living individuals suggest that frailty measures are mostly independent in younger individuals [ 29 , 30 ]. However, the aged care resident population is typically frail (75% frail and 19% pre-frail) [ 21 ], and a stronger correlation between all five metrics was expected. Inclusion and exclusion criteria in our trial purposefully excluded very frail individuals and may explain this finding.…”

“…The best measurement of three scores was used. To account for the influence of gender in grip strength [ 21 ], values were standardised by gender ( z score).…”

Effect of toileting behavior on daytime non-sedentary behavior in nursing home residents

“…Many residents of nursing homes are in a state of frailty. In a study conducted in 14 nursing homes in Australia, 75% of residents were frail, and 19% were considered "pre-frail" (Milte et al, 2022). Another study of nursing homes in Australia reported 43.8% of residents as frail and 38.4% as pre-frail (Ambagtsheer et al, 2020).…”