Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

Abstract

To clarify the possible association of frailty with hypertension prevalence, treatment and blood pressure (BP) control in the elderly, we conducted a screening survey of 1091 elderly community-dwelling subjects aged ≥65 years, using data from public health check-ups and frailty was determined by a 25-item questionnaire, the Basic Checklist for Frailty (BCF). The significance of differences in the association of BCF categories or BCF items with each hypertension status was analyzed using multiple logistic regression analysis after adjusting for age, sex and possible confounding underlying chronic conditions. A total of 63% of subjects were hypertensive (BP≥140/90 mm Hg), and of those, 85% were receiving antihypertensive treatment, and 56.0% of those receiving treatment had controlled BP (<140/90 mm Hg). BCF categories that showed an independent association with hypertension status were 'impaired walking status' and absence of 'impaired nutritional status' for prevalence of hypertension, 'impaired instrumental activity of daily living status' and 'impaired nutritional status' for untreated hypertension among hypertensives and 'impaired oral function' for BP-uncontrolled hypertension among treated hypertensives. In addition, BCF items that showed an independent association were 'inability to walk for more than 15 min without rest' and absence of 'Body mass index (BMI) <18.5 kg m(-2') for prevalence of hypertension, 'weight loss of more than 2-3 kg in the past 6 months' for untreated hypertension, and 'difficulty eating hard food' for BP-uncontrolled hypertension. These observations indicate that assessment of these specified frailty categories and/or items may be useful for evaluating hypertension status in elderly community-dwelling subjects.

Systematic review of the Kihon Checklist: Is it a reliable assessment of frailty?

“…24 There is no consensus regarding the division of the KCL domains; some researchers considered the first domain of the KCL as the first five questions (naming it "instrumental activities of daily living -IADL"), 12,17,20,23 whereas others considered it as the sixth to tenth questions, for example. Although the majority of studies divided the domains as aforementioned, exceptions were observed.…”

“…1,10 Furthermore, the next domain includes questions six to ten and has been named "physical strength domain," 11,15,20 "walking status domain," 14,23 "physical domain," 17 "motor function domain,"…”

“…We identified that the majority of authors maintained the Japanese term "Kihon Checklist" 11,15,17,20,21 or used similar terms, "Kihon-Checklist" 22 and "Kihon Check Lists." 12 In addition, some authors translated and denominated the checklist as "Basic checklist for frailty"; 23 "Basic questionnaire" and "basic checklist";…”

“…24 Questions 11 and 12 represent the "nutritional status domain" 11,14,15,23,25 or the "nutrition domain." 1,10,12,17,20 Questions 13-15 correspond to the "oral function domain," 1,[10][11][12]15,23,25 "eating domain" 17,20 or "dysphagia domain." 14 Questions 16 and 17 capture the "houseboundness domain," 11,15 "socialization domain," 17,20 "staying indoors domain," 23 "withdrawing into one's shell domain" 12 or "seclusion domain."…”

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

“…72 In a study by Koizumi et al, 73 frailty in hypertensive patients was associated with limited physical activity, lower body weight, difficulties in ingesting solid foods and performing daily activities, and limitations in performing complex activities of daily living, correlated with the prevalence, treatment and control of hypertension. 73 In another study, Talegawkar et al 74 investigated associations between frailty and adherence to the Mediterranean diet, and found that non-frail patients were more compliant with dietary recommendations than frail patients. 74 Contrary to the above, Chao et al report better adherence in frail patients, though not in the hypertensive population.…”