The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta‐Analysis

Chang, Shu‐Fang; Lin, Hsiang-Chun; Cheng, Chih-Ling

doi:10.1111/jnu.12397

Cited by 95 publications

(95 citation statements)

References 26 publications

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“…Chang et al reported in a meta‐analysis that frail older people showed the highest risk for hospitalization, followed by pre‐frail and robust older people . In a different study, MCI was associated with a 17% greater risk of hospitalization than normal condition (adjusted hazard ratio 1.17, 95% CI 1.02–1.34) .…”

Section: Discussionmentioning

confidence: 99%

Cognitive frailty in community‐dwelling older Japanese people: Prevalence and its association with falls

Kim

Awata

Watanabe

et al. 2019

Geriatrics Gerontology Int

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Aim To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people. Methods A total of 25 out of 1192 community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mini‐Mental State Examination. Physical function measures included calf circumference, Timed Up and Go (TUG) and usual walking speed. Interviews were carried out to assess Council on Nutrition Appetite Questionnaire (CNAQ); chronic diseases including hypertension, diabetes and falls; as well as physical frailty, defined as having three of five criteria: muscle weakness, slowness, exhaustion, low activity and weight loss. Results The prevalence of cognitive frailty was 2.1%. Participants with cognitive frailty had significantly reduced Mini‐Mental State Examination and calf circumference; and higher instrumental activities of daily living disability and falls. Old age (OR 1.151, 95% CI 1.053–1.257), fall history (OR 3.577, 95% CI 1.381–9.263), having four or more chronic diseases (OR 7.419, 95% CI 2.117–26.005) and slower TUG (OR 1.234, 95% CI 1.041–1.462) were significantly associated with cognitive frailty, whereas greater calf circumference (OR 0.748, 95% CI 0.625–0.895) and CNAQ (OR 0.736, 95% CI 0.628–0.8631) had protective effects. Old age (OR 1.132, 95% CI 1.002–1.280), hospitalization (OR 10.090, 95% CI 2.554–39.854), having four or more chronic diseases (OR 5.120, 95% CI 1.113–23.557) and slower TUG (OR 1.394, 95% CI 1.167–1.665) were significantly associated with cognitive frailty‐related falls, whereas CNAQ (OR 0.704, 0.571–0.868) had protective effects. Conclusions Age, chronic disease, TUG and CNAQ were significantly associated with cognitive frailty and cognitive frailty‐related falls. The TUG and CNAQ have the greatest potential for improvement by intervention or lifestyle change. Further research is necessary to determine the efficacy of positive changes in these factors for symptomatic improvements. Geriatr Gerontol Int 2019; 19: 647–653.

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Section: Discussionmentioning

confidence: 99%

Cognitive frailty in community‐dwelling older Japanese people: Prevalence and its association with falls

Kim

Awata

Watanabe

et al. 2019

Geriatrics Gerontology Int

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“…With the growing aging population worldwide, 1 frailty is increasingly an important issue because frailty is closely related to older age. 2 Many studies have shown that frail older people have an increased risk of disability, 3 hospitalization, 4 institutionalization, 5 lower quality of life, 6 and premature death. 7 The importance of paying attention to frailty is hardly disputed by research and practice; however, opinions differ widely about what qualifies as frailty.…”

Section: Introductionmentioning

confidence: 99%

<p>The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity</p>

Gobbens¹,

Boersma²,

Uchmanowicz³

et al. 2020

CIA

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Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls. Methods: The validity of the TFI was determined in a sample of 180 Dutch communitydwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later. Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) >0.8. In most cases, using the cutoff point 5 for total frailty ensured the best values for sensitivity and specificity. Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.

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“…Two meta-analyses including studies using the Fried phenotype found significant higher hospitalisation risk in frail compared with non-frail elderly individuals (OR: 1.49, CI: 1.26 to 1.76),14 and significant increased mortality (HR: 1.874, CI: 1.635 to 2.150) 15…”

Section: Introductionmentioning

confidence: 99%

Associations between the SHARE frailty phenotype and common frailty characteristics: evidence from a large Danish population study

et al. 2019

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ObjectivesFrailty is a major clinical geriatric syndrome associated with serious adverse events including functional disability, falls, hospitalisation, increased morbidity and mortality. The aim of this study was to study associations between a frailty phenotype and frailty characteristics well known from the literature.DesignRegistry-based cross-sectional study.SettingThe target population consists of inhabitants above the age of 50 living in the Danish municipalities of Lolland and Guldborgsund. Excluded are incapacitated people, inhabitants unable to understand Danish or English and inhabitants without a permanent residence.Participants7327 individuals aged 50+ years were included.Outcome measuresWe examined associations between the frailty measurement and factors known to be associated with frailty: sex, age, income insufficiency, education, comorbidity, self-assessed health, morbidity and mortality.Results7327 individuals aged 50+ years were included. Of these, 6.5% had ≥3 frailty components (frail), 46.7% had 1–2 components (prefrail) and 46.9% had none (non-frail). Those who were frail were older and more likely female than those who were non-frail or prefrail. There was a stepwise decrease in educational level, and in self-assessed health with increasing frailty status, and a stepwise increase in difficulty in making ends meet, number of hospital contacts and mortality with increasing frailty status, p<0.0001 for each comparison. Compared with individuals who were non-frail, mortality was higher among those who were prefrail (HR: 2.90; 95% CI: 1.30 to 6.43) or frail (HR: 8.21; 95% CI: 3.37 to 20.0).ConclusionsBased on these findings, we consider the Lolland-Falster Health Study frailty assessment a valid instrument demonstrating the same characteristics as other validated frailty measures concerning associations with sex, age, income insufficiency, education, comorbidity, self-assessed health, morbidity and mortality.Trial registration numberNCT02482896.

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The Relationship of Frailty and Hospitalization Among Older People: Evidence From a Meta‐Analysis

Abstract: Professional nursing staff should use frailty indicators in a timely fashion to assess the status of frailty in older people and should effectively develop frailty prevention strategies to decrease the risk for hospitalization and to enhance quality of life for older adults.

Cited by 95 publications

References 26 publications

Cognitive frailty in community‐dwelling older Japanese people: Prevalence and its association with falls

Cognitive frailty in community‐dwelling older Japanese people: Prevalence and its association with falls

<p>The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity</p>

Associations between the SHARE frailty phenotype and common frailty characteristics: evidence from a large Danish population study

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