Factors Determining the Occurrence of Frailty Syndrome in Hospitalized Older Patients

Abstract

Frailty syndrome (FS) is a condition characterized by a decline in reserves, observed with aging. The most important consequences of the frailty syndrome include disability, hospitalization, fractures, institutionalization, and early mortality. The aim of this study was to identify the most important risk factors for FS in a group of older hospitalized patients in Poland. A total of one hundred and forty-one (78 women, 63 men) elderly patients from the Departments of Internal Medicine of the Medical University of Lodz (Poland) were recruited for this study. Frailty Instrument of the Survey of Health, Aging and Retirement in Europe (SHARE-FI), handgrip strength (HGS), depressive symptoms using the Geriatric Depression Scale (GDS), and functional ability (FA) using the Instrumental Activities of Daily Living (IADL) were assessed. According to SHARE-FI score, participants were divided into control group, frail, and pre-frail patients. Out of all 141 tested patients, FS was confirmed in 55 patients, and pre-frailty was observed in 52 patients. The occurrence of FS in the group of studied patients was related to age (p < 0.001), widowhood (p < 0.001), comorbidities (p < 0.001), heart diseases (p = 0.04), more medications taken (p < 0.001), lower FA (p < 0.001), weaker HGS, and depression (p < 0.001). The strongest positive correlations were between Share-FI score and the number of diseases (rS = 0.31), GDS (rS = 0.32), while negative correlations with IADL (rS = −0.47) and HGS (rS = −0.35). The study shows that FS is associated with age, comorbidities, number of medications taken, and widowhood. The present study has also demonstrated that FA, depression, and especially HGS are essential determinants of FS of elderly hospitalized people.

The Influencing Factors of Frailty and Quality of Life in Elderly Patients After Spinal Surgery

“…There are also many studies at home and abroad that reported that age is one of the independent risk factors for frailty. 12 , 13 Some Chinese scholars analyzed the risk factors of frailty in 3836 cases of geriatric internal medicine patients and found that aging is the risk factor of frailty. 8 Our research also confirms this.…”

The Prevalence of the Frailty Syndrome in a Hospital Setting—Is Its Diagnosis a Challenge? A Comparison of Four Frailty Scales in a Cross-Sectional Study

“…In the other Polish studies on hospital inpatients, the incidence of frailty syndrome assessed using the Fried criteria was 54.2% [ 25 ], using the Edmonton scale—12.3% (mean age 62.6+/−9.7y) [ 36 ], and SHARE-FI (mean age 73 (68–81)y) − 39% [ 37 ]. In another Polish study, in patients hospitalized due to heart failure (mean age 71.6 ± 10.9 years), frailty frequency using the Tilburg Frailty Indicator scale was 71.62% [ 38 ].…”

A Narrative Review of the Utilisation of the SHARE Frailty Instruments (SHARE-FI and SHARE-FI75+) in the Literature

“…However, an observational study with patients presenting to an Irish Emergency Department (ED) study found no correlation with age 16 . Lower education and socioeconomic status, and living alone were found to be associated with frailty in one study including a mix of community-dwelling and nursing home participants 15 ; while another study in hospitalised older patients found no significant associations 25 . In a study with 22 institutionalised older adults in Italy (mean age 84), frailty as assessed by SHARE-FI was associated with more variance and cross-correlation in self-rated physical, mental, and social health over 100 consecutive days 26 .…”

“…Outside community settings, age was also found to be positively correlated with frailty 15,25 . However, an observational study with patients presenting to an Irish Emergency Department (ED) study found no correlation with age 16 .…”