Frailty status changes are associated with healthcare utilization and subsequent mortality in the elderly population

Abstract

Background This study determined (1) whether a change in frailty status after a 1 year follow up is associated with healthcare utilization and evaluated (2) whether a change in frailty status after a 1 year follow up and health care utilization are associated with all-cause mortality in a sample of Taiwan population. Methods This work is a population-based prospective cohort study involving residents aged ≥65 years in 2009. A total of 548 elderly patients who received follow-ups in the subsequent year were included in the current data analysis. Fried frailty phenotype was measured at baseline and 1 year. Information on the outpatient visits of each specialty doctor, emergency care utilization, and hospital admission during the 2 month period before the second interview was collected through standardized questionnaires administered by an interviewer. Deaths were verified by indexing to the national database of deaths. Results At the subsequent 1 year follow-up, 73 (13.3%), 356 (64.9%), and 119 (21.7%) elderly participants exhibited deterioration, no change in status, and improvement in frailty states, respectively. Multivariate logistic analysis showed the high risk of any type of outpatient use (odds ratios [OR] 1.94, 95% confidence interval [CI] 1.02–3.71) among older adults with worse frailty status compared with those who were robust at baseline and had unchanged frailty status after 1 year. After multivariate adjustment, participants with high outpatient clinic utilization had significantly higher mortality than those with low outpatient clinic visits among unchanged pre-frail or frail (hazard ratios [HR] 2.79, 95% CI: 1.46–5.33) and frail to pre-frail/robust group (HR 9.32, 95% CI: 3.82–22.73) if the unchanged robustness and low outpatient clinic visits group was used as the reference group. Conclusions The conditions associated with frailty status, either after 1 year or at baseline, significantly affected the outpatient visits and may have increased medical expenditures. Combined change in frailty status and number of outpatient visits is related to increased mortality.

Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study

“…Other authors, working with the same survey [24,74,83] or with other data [18], arrived at a similar selection of health domain-related indicators (diseases, dependency and physical or cognitive functioning) [84]. This paper has expanded the health-related indicators by adding others linked to the use of medical services [85], nutrition [86] and alcohol consumption [87]; all of them have been related to functionality, morbidity and/or mortality [85][86][87]. As regards the Participation pillar, SHARE provides information on the type of activities carried out and their frequency, usually considered by most authors [88][89][90][91][92].…”

Caring for Frail Older People Living Alone in Italy: Future Housing Solutions and Responsibilities of Family and Public Services, a Qualitative Study

“…For older people living alone, supporting their ability to age in place, e.g., in their own home [ 1 ], becomes crucial when limitations in their physical functionalities compromise performing the activities of daily living. Thus, community-dwelling older adults, especially those with limited informal and formal care supports, face a high risk of becoming frail [ 2 ], and during the experience of transitioning toward residential care facilities, older people face substantial challenges (e.g., changes life patterns, isolation, loss of autonomy, stress) [ 3 ].…”

Hyperglycemia and Physical Impairment in Frail Hypertensive Older Adults

“…Frailty is a multidimensional condition typical of elders that determines physical decline. Frail older adults have a high risk of functional decline, hospitalization, and mortality ( 1 – 4 ). Hence, a careful geriatric evaluation is one of the best strategies to obtain an early diagnosis of physical impairment, and managing comorbidities and complications is fundamental to counteract it ( 5 – 11 ).…”