A New Functional Classification Based on Frailty and Disability Stratifies the Risk for Mortality Among Older Adults: The FRADEA Study

Hoogendijk, Emiel O.; Romero, Luis; Sánchez-Jurado, Pedro Manuel; Ruano, Teresa Flores; Viña, José; Rodríguez‐Mañas, Leocadio; Abizanda, Pedro

doi:10.1016/j.jamda.2019.01.129

Cited by 50 publications

(44 citation statements)

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“…All 198 residents were identified and assessed, but we could only identify 147 workers for complete assessment. Demographics and functional status with the Barthel index [ 15 ], Lawton index [ 16 ], FRAIL instrument [ 17 ], Functional Ambulation Classification [ 18 ], and the New Functional Classification [ 19 ] were determined. Cognitive status and nutritional situation with the Mini Nutritional Assessment Short Form (MNA-SF) [ 20 ] were assessed, and comorbidity was determined with the Charlson index [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

et al. 2020

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Background/Objectives To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain. Design Epidemiological study. Setting Six open LTCFs in Albacete (Spain). Participants 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents. Measurements Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed. Results The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals. Conclusion The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high.

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Section: Methodsmentioning

confidence: 99%

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

et al. 2020

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“…There are currently two major models of frailty: first, the frailty phenotype model that views frailty from the physiological systems and defines frailty as several biological syndromes [8]; second, the frailty deficit model measures frailty as problems resulting from a multidimensional system, including biological, physiological and psychological [9]. Despite a sizeable literature on the adverse outcomes of frailty, such as falls [10], disability [11,12], hospitalization [13], institutional care [14,15], and mortality [16][17][18], relatively little is known about the transition of frailty in older people. Although frailty is inevitable with increasing age [19], it is not irreversible but agreeable to be a dynamic process involving improvement and natural procession [4].…”

Section: Introductionmentioning

confidence: 99%

Loneliness as a risk factor for frailty transition among older Chinese people

Sha

Chen

2020

BMC Geriatr

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Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people. Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty. Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR = 0.78, 95%CI: 0.68-0.91, p < 0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01-1.41, p < 0.05) after 3 years and 1.34 (95%CI: 1.08-1.66, p < 0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR = 1.78, 95%CI: 1.25-2.55, p < 0.01; often loneliness: OR = 1.74, 95%CI: 1.21-2.50, p < 0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants. Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

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“…There are currently two major models of frailty: rst, the frailty phenotype model that views frailty from the physiological systems and de nes frailty as several biological syndromes [8]; second, the frailty de cit model measures frailty as problems resulting from a multidimensional system, including biological, physiological and psychological [9]. Despite a sizeable literature on the adverse outcomes of frailty, such as falls [10], disability [11,12], hospitalization [13], institutional care [14,15], and mortality [16][17][18], relatively little is known about the transition of frailty in older people. Although frailty is inevitable with increasing age [19], it is not irreversible but agreeable to be a dynamic process involving improvement and natural procession [4].…”

Section: Introductionmentioning

confidence: 99%

Loneliness as a risk factor for frailty transition among older Chinese people

Sha

Chen

2020

Preprint

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Background: Previous literature has reported that loneliness is a strong predictor of frailty risk. However, less is known about the role of loneliness in frailty transition types. This study aimed to examine whether and how loneliness are related to frailty transition among older Chinese people.Methods: Our study used participants (aged ≥60 years) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely. The FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of the frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: Greater loneliness at baseline reduced the possibility of remaining in a robust or prefrail physical frailty state after 3 years (OR=0.78, 95%CI: 0.68–0.91, p<0.01). Greater loneliness was associated with an increased risk of worsening physical frailty over time: compared with those who had never felt lonely, the odds ratios for people who often felt lonely were 1.19 (95%CI: 1.01–1.41, p<0.05) after 3 years and 1.34 (95%CI: 1.08–1.66, p<0.01) after 6 years. The association between loneliness and change in the frailty index differed in the survey periods: loneliness at baseline was found to increase the possibility of participants remaining in frailty (seldom loneliness: OR= 1.78, 95%CI: 1.25–2.55, p<0.01; often loneliness: OR= 1.74, 95%CI: 1.21–2.50, p<0.01) after 6 years, but no significance was shown in the 3-year follow up. Additionally, loneliness at baselines was significantly associated with frailty transition at follow up among the male participants. However, a similar association was not observed among the female participants.Conclusion: Older people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to an increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to have a worse frailty transition than female elderly in China.

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A New Functional Classification Based on Frailty and Disability Stratifies the Risk for Mortality Among Older Adults: The FRADEA Study

Cited by 50 publications

References 38 publications

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

COVID-19 outbreak in long-term care facilities from Spain. Many lessons to learn

Loneliness as a risk factor for frailty transition among older Chinese people

Loneliness as a risk factor for frailty transition among older Chinese people

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