The Contribution of Frailty to Participation of Older Adults

Abstract

Background: Participation, which is involvement in life situations, is an important indicator of human health and well-being of older adults. Frailty is known to be related to difficulties in activities of daily living (ADL) but the association with participation restriction has not been sufficiently researched. Therefore, we aimed to (1) to assess the correlations between frailty, ADL, and participation; and (2) to identify the contribution of frailty to explaining the participation restriction of older adults. Methods: A cross-sectional study included home visits to community-dwelling older adults aged 75 and older. The Reintegration to Normal Living Index (RNL-I) assessed participation, PRISMA-7 assessed frailty, and the Functional Independence Measure and IADL questionnaire assessed the basic and instrumental ADL. Cognition, which may explain participation, was also assessed (The Montreal Cognitive Assessment) and demographic information was collected. Results: Older adults (N = 121, 60 women), aged 75 to 91 years (mean (SD)—79.6 (3.1)), were included. Older adults demonstrated full to restricted participation (RNL-I-mean (SD)—78.2 (18.0)/100). Frailty was identified in 39 (32%) older adults (mean (SD) PRISMA-7—2.9 (1.4)/7points). A negative moderate significant correlation was found between participation and frailty (r = −0.634, p < 0.001). The variance of participation was significantly explained by frailty, 31.5%, and basic ADL, 5.6% (after controlling for age and cognition); the total model explained 44.6% (F = 23.29, p < 0.001). Conclusions: Frailty is significantly associated with participation restriction. Since participation has many health benefits, understanding which factors are associated to participation is central to developing interventions for older adults. These findings may help health professionals in the future develop interventions for maintaining and promoting the participation of older adults.

Caring for Frail Older People Living Alone in Italy: Future Housing Solutions and Responsibilities of Family and Public Services, a Qualitative Study

“…Frailty is “an ageing-related syndrome of physiological decline, multisystem dysfunction, and susceptibility to adverse consequences” [ 4 ] (p. 2), representing a crucial public health challenge affecting population ageing [ 5 , 6 ], being a geriatric syndrome that increases vulnerability to adverse health outcomes [ 7 , 8 ]. The interaction between older age and chronic diseases can result in increased frailty, which in turn can lead to disability, hospitalization, and also death [ 9 , 10 , 11 ]. The literature often relates the physical characteristics of frailty to difficulties in performing basic and instrumental Activities of Daily Living (ADLs and IADLs) [ 12 , 13 ].…”

Investigating the effects of frailty on longer-term outcomes in older major trauma patients: a multi-site study.

“…Injury in older people can lead to a process of activity restrictions and isolation which negatively in uences psychological quality of life [36]. The effects of frailty can also adversely affect engagement in usual activities [37,38] which may also impact on mood and mental health. In hip fracture populations frailty on admission has been reported as a strong prognostic factor for depressive symptoms up to a year after injury [39].…”