Frailty in Older Adults: A Nationally Representative Profile in the United States

Bandeen‐Roche, Karen; Seplaki, Christopher L.; Huang, Jin; Buta, Brian; Kalyani, Rita R.; Varadhan, Ravi; Qin, Xue; Walston, Jeremy D.; Kasper, Judith D.

doi:10.1093/gerona/glv133

Cited by 620 publications

(515 citation statements)

References 27 publications

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“…A new study conducted by Tan et al demonstrated that frailty is associated with a higher number of falls and falls with serious consequences (36). Bandeen et al determined that the incidence of falls in the past year was 30.5% in the robust population, 32.9% in prefrail patients, and 54.9% in frail patients (25). A metaanalysis carried out recently by Kojima et al demonstrated that male, frail, community-dwelling older adults are subject to higher fall risks (23).…”

Section: Discussionmentioning

confidence: 99%

Quality of life and fall risk in frail hospitalized elderly patients

Öztürk¹,

Özdemir²,

Türkbeyler³

et al. 2017

Turk J Med Sci

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Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients.Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics. The Cardiovascular Health Study (CHS) frailty scale, Health-Related Quality of Life Short Form (SF-36) scale, and Hendrich II Fall Risk Model were administered to the patients. Demographic data of patients, number of chronic diseases, and information on used medication were also collected. Results:The median age of patients was 71.9 ± 6.3 years and 49.5% of the patients were female. By applying the CHS frailty scale, the proportion of frail patients was determined to be 65.5%. There were statistically significant differences among quality of life mean scores of robust, prefrail, and frail patients (P < 0.001). Frail patients had the lowest scores in all SF-36 subgroups. Eighty-three (19.8%) patients were in the low-risk group while 337 (80.2%) were high-risk according to the Hendrich II Fall Risk Model. The rate of patients with high falling risk and poor QoL reached a maximum in the frail group (96%). Conclusion:Frailty is an important geriatric syndrome in elderly hospitalized patients. Poor QoL and high falling risk are issues commonly experienced with frailty.

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Section: Discussionmentioning

confidence: 99%

Quality of life and fall risk in frail hospitalized elderly patients

Öztürk¹,

Özdemir²,

Türkbeyler³

et al. 2017

Turk J Med Sci

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“…A study carried out in the USA with 7.439 elderly aged 65 or older found a 15% prevalence of frailty, and the main risk factors were: advanced age, female sex, low income, racial/ethnic minorities and the presence of multiple chronic diseases (8) .…”

Section: Introductionmentioning

confidence: 99%

Elderly who take care of elderly: a study on the Frailty Syndrome

et al. 2017

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Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a signifi cant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services. Descriptors: Caregivers; Fragile Elderly; Geriatric Nursing; Social Vulnerability; Family Health. RESUMO Objetivo: Identifi car a prevalência de fragilidade em cuidadores idosos inseridos em contexto de alta vulnerabilidade social e sua correlação com aspectos sociodemográfi cos e de saúde. Método: Estudo descritivo, correlacional, transversal. Foram avaliados 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. As entrevistas foram realizadas no domicílio, sendo previamente agendadas. Todos os cuidados éticos foram observados. Os dados foram analisados com apoio do pacote estatístico Stata versão 11.0. Resultados: 10,0% dos cuidadores idosos eram frágeis. Houve correlação signifi cativa entre fragilidade e: sexo, atividades instrumentais de vida diária e cognição. Conclusão: Cuidadoras do sexo feminino, indivíduos parcialmente dependentes em relação às atividades instrumentais de vida diária e com pior estado cognitivo merecem especial atenção dos serviços de saúde. Descritores: Cuidadores; Idoso Fragilizado; Enfermagem Geriátrica; Vulnerabilidade Social; Saúde da Família. RESUMENObjetivo: Identifi car la existencia de la fragilidad en ancianos cuidadores en un contexto de elevada vulnerabilidad social y su correlación con aspectos sociodemográfi cos y sanitarios. Método: Estudio descriptivo, correlacional, transversal. Se evaluaron a cuarenta ancianos cuidadores empleando: un cuestionario para conocer el cuidador, el Miniexamen del Estado Mental, el Índice de Katz, la Escala de actividades instrumentales de la vida diaria de Lawton, la Escala de depresión geriátrica y el fenotipo de fragilidad, de Fried. Se realizaron las entrevistas en las residencias con fecha y horario agendado. Se observaron todos los cuidados éticos. Se evaluaron los datos mediante el software Stata, ve...

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“…1 National data from the United States suggest that 15% of community-dwelling persons aged 65 years or older are frail and 45% are prefrail. 2 The high prevalence of frailty is a significant public health problem. The older adult population is growing, and frailty is associated with increased risk of disability, hospitalization, and mortality.…”

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confidence: 99%

Frailty, Kidney Function, and Polypharmacy: The Atherosclerosis Risk in Communities (ARIC) Study

Ballew

Chen

Daya

et al. 2017

American Journal of Kidney Diseases

108

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Background Frail individuals are at increased risk for poor outcomes, including adverse drug events. Kidney function is often compromised in frailty and is a key consideration in medication choice and dosing; however, creatinine-based measures of kidney function may be biased in frail individuals. Study Design Observational study. Setting & Participants 4,987 community-dwelling older men and women with complete data who participated in visit 5 of the Atherosclerosis Risk in Communities (ARIC) Study (2011–2013). Predictor Kidney measures included glomerular filtration rate (GFR) estimated using serum creatinine (eGFRcr) and serum cystatin C (eGFRcys) and urine albumin-creatinine ratio (ACR). Outcomes Frailty, defined using established criteria of 3 or more frailty characteristics (weight loss, slowness, exhaustion, weakness, and low physical activity). Results In total, 341 participants (7%) were classified as frail, 1475 (30%) had eGFRcr <60 ml/min/1.73 m2, 2480 (50%) had eGFRcys <60 ml/min/1.73 m2, and 1006 (20%) had albuminuria ≥30 mg/g. Among frail participants, prevalences of eGFRcr and eGFRcys <60 ml/min/1.73 m2 were 45% and 77%, respectively. Adjusted for covariates, frailty showed a moderate association with eGFRcr and a strong association with eGFRcys and ACR. Frail individuals with eGFRcr 60–<75 ml/min/1.73 m2 were frequently reclassified to lower eGFR categories using eGFRcys (49% to 45–<60, 32% to 30–<45, and 3% to <30 ml/min/1.73 m2). Hyperpolypharmacy (taking ≥10 classes of medications) was more common in frail individuals (54% vs 38% of non-frail), including classes requiring kidney clearance (e.g., digoxin) and associated with falls and subsequent complications (e.g., hypnotic/sedatives, anticoagulants). Limitations Cross-sectional study design. Conclusions Frail individuals had a high prevalence of reduce kidney function, with large discrepancies when reduced kidney function was classified by eGFRcys versus eGFRcr. Given the substantial medication burden and uncertainty in CKD classification, confirmation of kidney function with alternative biomarkers may be warranted to ensure careful prescribing practices in this vulnerable population.

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Frailty in Older Adults: A Nationally Representative Profile in the United States

Abstract: Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.

Cited by 620 publications

References 27 publications

Quality of life and fall risk in frail hospitalized elderly patients

Quality of life and fall risk in frail hospitalized elderly patients

Elderly who take care of elderly: a study on the Frailty Syndrome

Frailty, Kidney Function, and Polypharmacy: The Atherosclerosis Risk in Communities (ARIC) Study

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