The importance of different frailty domains in a population based sample in England

Abstract

Background: The aim was to estimate the prevalence of frailty and relative contribution of physical/balance, nutritive, cognitive and sensory frailty to important adverse health states (falls, physical activity levels, outdoor mobility, problems in self-care or usual activities, and lack of energy or accomplishment) in an English cohort by age and sex. Methods: Analysis of baseline data from a cohort of 9803 community-dwelling participants in a clinical trial. The sample was drawn from a random selection of all people aged 70 or more registered with 63 general practices across England. Data were collected by postal questionnaire. Frailty was measured with the Strawbridge questionnaire. We used cross sectional, multivariate logistic regression to estimate the association between frailty domains and known correlates and adjusted for age. Some models were stratified by sex. Results: Mean age of participants was 78 years (sd 5.7), range 70 to 101 and 47.5% (4653/9803) were men. The prevalence of overall frailty was 20.7% (2005/9671) and there was no difference in prevalence by sex (Odds Ratio 0.98; 95% Confidence Interval 0.89 to 1.08). Sensory frailty was the most common and this was reported by more men (1823/4586) than women (1469/5056; Odds Ratio for sensory frailty 0.62, 95% Confidence Interval 0.57 to 0.68). Men were less likely than women to have physical or nutritive frailty. Physical frailty had the strongest independent associations with adverse health states. However, sensory frailty was independently associated with falls, less frequent walking, problems in self-care and usual activities, lack of energy and accomplishment. Conclusions: Physical frailty was more strongly associated with adverse health states, but sensory frailty was much more common. The health gain from intervention for sensory frailty in England is likely to be substantial, particularly for older men. Sensory frailty should be explored further as an important target of intervention to improve health outcomes for older people both at clinical and population level. Trial registration: ISRCTN71002650.

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

“…These results suggest that in non-demented older adults, frailty and MBI are both common and associated with small but significant impairment in global cognition. The prevalence of frailty was 30.7% in our study, which was relatively high compared with previous estimates, which ranged from 11% up to 26% in community samples [63][64][65]. This difference may be attributed to our study design and to the fact that participants came from primary care clinics.…”

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

“…The prevalence of frailty was 30.7% in our study, which was relatively high compared with previous estimates, which ranged from 11% up to 26% in community samples (64)(65)(66). This difference may be attributed to our study design and to the fact that participants came from primary care clinics.…”

Mild behavioral impairment is related to frailty in non-dementia older adults: a cross-sectional study

“…While the prevalence of frailty was 30.7% in all participants and 69.3% for no-frailty. The prevalence of frailty in our study was relatively high compared with previous estimates, which ranged from 11% up to 26% in community samples (51)(52)(53), and the difference may be attributed to our study design and to the fact that participants came from primary care clinics. Frailty may increase the risk of future cognitive decline and that cognitive impairment may increase the risk of frailty suggesting that cognition and frailty may interact in the cycle of age-related decline (54,55).…”