Frailty and Related Factors Based On A Multidimensional Assessment In People 70 Years Old Or Over

Abstract

Introduction: The Healthcare Plan for the Elderly (PAM) of the Basque Public Health Service (Osakidetza) determines different typologies of people ≥70 years of age based on a multidimensional assessment. The objective is to learn about the prevalence of frailty and its relationship with other variables of the assessment. Material and methods:Cross-sectional study with a sample of 666 people (569 with a certain typology determined)≥70 years of age from 7 healthcare centres, selected by random sampling. Different typologies were determined based on functionality (Instrumental Activities of Daily Living -IADL, Lawton-Brody Index; Basic Activities of Daily Living -BADL, Barthel Index), existence of chronic diseases, and life expectancy < 6 months: 'healthy older person', 'with a chronic disease but no relevant alteration of functionality', 'FRAIL' (alteration of IADL, Barthel>59, life expectancy>6 months), 'dependent', and 'at the end of life'.Results: The 19.2% (95% CI 16.1-22.6%) were frail. Frailty was significantly related (p<0.001) to age (66.1% > 80 years old versus 27.2% non-frail), physical inactivity (57.1 versus 15.4%), previous falls (58.4% versus 34.2%) and number of chronic medications (median 13 versus 8). It was also related to certain pathologies (cardiovascular, osteoarticular) and visual deficit. Detection through the assessment of IADL is closely related to the Timed Up and Go Test (p<0.001). Conclusions:In order to detect frailty, it is important to consider older age, physical inactivity, certain comorbidity (cardiovascular, osteoarticular, sensory) and polypharmacy. IADL and performance-based tests show very good correlation.Keywords: frail elderly, geriatric assessment, activities of daily living, primary care. The objective of this study is to determine the prevalence of frail people ≥ 70 years old, according to PAM criteria based on functionality (alteration in the Lawton-Brody Index, Barthel Index ≥ 60 points), and life expectancy > 6 months; and assess the relationship of frailty with other variables of the multidimensional assessment. MOJ Gerontology & Geriatrics Material and methods Study design and locationThis is a cross-sectional study based on the PAM multidimensional clinical assessment, encompassed in the pilot period of this programme prior to its extension. It was carried out in 7 healthcare centres of the Basque Autonomous Community in Spain, 4 in urban areas, 1 in a semi-urban area and 2 in rural areas. The assessments were conducted from 11 January to 15 April 2016. Study population and samplePeople ≥ 70 years old were included through random sampling stratified by healthcare centre, excluding those institutionalised in residences with their own healthcare professionals caring for them there. A minimum sample size of 377 subjects was estimated, considering the most unfavourable of the situations to determine the percentages of appearance of an event-variable in the assessment (50%), for a reference population > 20,000 people in the Basque Autonomous Community (higher t...