Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

Abstract

Background: It is important to clarify the transitions and related factors of frailty for prevention of frailty. We evaluated the transitions of frailty among community-dwelling older adults and examined the predictors of the transitions. Methods: A cohort study was conducted among 3988 community residents aged ≥60 years during 2015 and 2017. A multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected in 2015. After 2-year follow-up, the transitions of frailty between baseline and were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the transitions of frailty. Results: The proportion of robust, prefrail, and frail was 79.5, 16.4, and 4.1% among 3988 participants at baseline, which changed to 68.2, 23.0, and 8.8% after 2 years with 127 deaths and 23 dropped out. Twelve kinds of transitions from the three frailty statuses at baseline to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement.

Frailty transitions and cognitive function among South Korean older adults

“…Frailty has been widely recognized as a geriatric syndrome and an emerging risk factor for adverse health outcomes in older adults. Frailty in older adults is linked to a greater risk of falls, hospitalization, disability, and death 1 , 2 . In Korea, reports indicate that the prevalence of frailty ranges from 2.5 to 31.7%, depending on the study sample and frailty scale measure 3 – 5 .…”

Did the number of older adults with frailty increase during the COVID-19 pandemic? A prospective cohort study in Japan

“…In the study over 2 years of follow-up, it was reported that 6.9% older adults were aged 60 years and above [ 8 ]. In another study in Japan, it was reported that 7.2% older adults’ mean age was 73.0 [ 7 ].…”

“…Previous studies reported frailty transition rates based on their longitudinal research period [ 5 – 8 ]. However, the frailty transition rate might be different from the norm period since no one has ever experienced the impact of COVID-19 countermeasures earlier and thus, it cannot be predicted.…”

Influencing Factors of Undermet Care Needs of the Chinese Disabled Oldest Old People When Their Children Are Both Caregivers and Older People: A Cross-Sectional Study

“…According to a review of previous research, the influencing factors of the undermet care needs of the disabled oldest old people were divided into the following categories in this study: (1) sociodemographic characteristics, including sex, age, education, marital status, place of residence and frailty index [ 46 , 53 , 54 , 55 , 56 ]. The frailty index was composed of eight parts, including the ADL, IADL (instrumental activities of daily living), objective physical performance, cognitive function, chronic disease, self-rated and interviewer-rated health, visual and hearing impairment, and number of times suffered from a serious illness in the past 2 years, which ranged from 0 to 1, with higher scores indicating weaker physical and mental functions of the oldest old people [ 57 , 58 ]. It should be pointed out that the Chinese version of MMSE (Mini-mental State Examination) is mainly used to measure the cognitive function of the older people, which is considered to be effective and applicable [ 6 , 12 ]; (2) family endowment, also called family resource, includes the human resources, economic resources, material resources, and social network resources which is the family actually or potentially owns.…”