Healthcare cost expenditures associated to frailty and sarcopenia

Abstract

Objectives Frailty and sarcopenia have been related with adverse events, including hospitalization. However, its combined effect with hospitalization-related outcomes, including costs, has not been previously investigated. Our purpose was to explore how frailty, sarcopenia and its interaction could impact on healthcare expenditures. Methods 1358 community-dwelling older adults from the Toledo Study of Healthy Ageing (TSHA) were included. Sarcopenia was measured using the Foundation for the National Institutes of Health criteria fitted to our cohort. Frailty was defined according to Frailty Trait Scale 5 (FTS5) and the Frailty Index fitted to the cut-off points of TSHA population. Hospitalization costs were taken from hospital records and costs were attributed according to Diagnostic-Related Groups, using as the cost base year 2015. Two-part regression models were used to analyze the relationship between frailty and sarcopenia and hospital admission, number of hospitalizations, length of stay and hospitalization costs. Results Sarcopenia was associated only with the probability of being admitted to hospital. Frailty was also associated with higher hospital use, regardless of the frailty tool used, but in addition increased hospital admission costs at follow-up by 23.72% per year and by 19.73% in the full model compared with non-frail individuals. The presence of sarcopenia did not increase the costs of frailty but, by opposite, frailty significantly increased the costs in people with sarcopenia, reaching by 46–56%/patient/year at follow-up. Older adults with frailty and sarcopenia had a higher risk of hospitalization, disregarding the tool used to assess frailty, and higher hospitalization costs (FTS5) in the full model, at the cross-sectional and at the follow-up level. Conclusions Frailty is associated with increased hospitalization costs and accounts for the potential effects of sarcopenia.

Effect of Familial Longevity on Frailty and Sarcopenia: A Case–Control Study

“…Notwithstanding the above, and although long-lived families may also have healthier living habits or better socioeconomic conditions, the benefits associated with family longevity appear to be independent of such factors and may be largely attributable to a genetic influence [ 82 ]. In this way, we observed a 22% attributable fraction in the population, which is similar to the Robustness Index Ratio observed by Serena Dato et al in the Longitudinal Study of Aging Danish Twins [ 6 ].…”

“…Frailty and sarcopenia have emerged as two key geriatric syndromes in the aging process and have been associated with adverse events, including falls, fractures, functional impairment, disability, cognitive impairment, hospital admissions, and institutionalization [ 3 , 4 , 5 ]. These events are likely to limit the quality of life and longevity and increase healthcare costs [ 6 ]. Longevity, on the other hand, has been positively associated with a lower frequency of sarcopenia and a delay in the onset of physical frailty and cognitive impairment [ 7 ].…”

A systematic review and meta-analysis of the association between sarcopenia and myocardial infarction

“…Healthcare systems are under great stress with an increasing demand resulting from the ageing of the population [ 34 ], because various potential physiological changes and a higher risk of diseases emerge with ageing [ 35 ]. Sarcopenia and weakness are two common geriatric syndromes [ 2 ] and these two conditions are closely related [ 36 ].…”

Sarcopenia index as a predictor of clinical outcomes among older adult patients with acute exacerbation of chronic obstructive pulmonary disease: a cross-sectional study

“…Sarcopenia is a syndrome characterized by a progressive decline in skeletal muscle mass, strength, and function in older people [ 6 ]. It is closely related to osteoporosis and frailty syndrome and can increases the risks for adverse health outcomes such as falls, physical disability, hospital admission, poor quality of life, and mortality risk [ 7 , 8 ]. In patients with COPD, sarcopenia is a common comorbidity and its prevalence is estimated to range from 15 to 55% [ 9 ].…”