Once frail, always frail? Frailty transitions in home care users with intellectual and developmental disabilities

Martin, Lynn; McKenzie, Katherine; Ouellette‐Kuntz, Hélène

doi:10.1111/ggi.13214

Cited by 12 publications

(44 citation statements)

References 24 publications

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“…The present study showed that frailty status can deteriorate to a worse state (22.2%) but can also turn back to a better state (7.8%), though the majority stayed in the same state (70.0%). These results are similar to previous studies, [33,38,39] and continue to support the notion that frailty is a dynamic and reversible status in later life. [40] With increasing age, the risk of being frailty and frailty worsening were both higher.…”

Section: Discussionsupporting

confidence: 93%

“…However, after adjusting for lifestyle factors, it seemed that few differences in changes of frailty were consistent with previous studies. [18,39] These findings suggest that females probably have worse health but a more protective lifestyle, which provides a reason for the health-survival paradox. A higher educational level, known to promote better psychological well-being and less dependence, [42] was found to be associated with decreasing frailty among baseline robust elders in a previous study [22] and in the current study.…”

Section: Discussionmentioning

confidence: 95%

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Changes in Frailty among Community-Dwelling Older Chinese Adults and its Predictors: Evidence from a Two-Year Longitudinal Study

Chen

Huang

et al. 2020

Preprint

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Background: Understanding the characteristics related to frailty transitions will allow for better future health practice and healthcare strategies. We evaluated the changes in frailty among communitydwelling older adults and to examine the predictors of the changes in frailty. Methods: A total of 4050 community residents aged ≥ 60 years were recruited in 2015 with follow-up after 2 years. At baseline, a multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected. The transitions in frailty between baseline and 2-year follow-up were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the changes of frailty, adjusting for all of the covariates. Results: Of all of the 3988 participants at baseline, those with frailty status of robust, prefrail, and frail were 79.5%, 16.4%, and 4.1%, and these changed to 68.2%, 23.0%, and 8.8% after 2 years with 127 deceased and 23 dropped out. Twelve kinds of transitions from baseline of the three frailty statuses to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement. Conclusions: The status of frailty was reversible among community-dwelling elderly, and sociodemographic and lifestyle factors were related to changes in frailty. These findings help health practitioners to recognize susceptible individuals in a community and provide health promotional planning to target aged populations. BackgroundFrailty is an unstable status with the age-related loss of physiological reserves and disorders in 4 homeostatic systems. [1,2] The presence of frailty is not only symptomatic in older individuals, but it also renders them more prone to downstream changes in long-term health outcomes, such as disability, hospitalization, institutionalization, and mortality. [1,[3][4][5][6] In the absence of a gold standard, the two approaches most widely used are frailty phenotype (FP)[1] and frailty index (FI).[7] FP is defined on the basis of weight loss, exhaustion, physical activity, walk time, and grip strength, while FI is defined as an individual's accumulated proportion of lis...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 95%

Changes in Frailty among Community-Dwelling Older Chinese Adults and its Predictors: Evidence from a Two-Year Longitudinal Study

Chen

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The present study showed that frailty status can deteriorate to a worse state (22.2%) but can also turn back to a better state (7.8%), though the majority stayed in the same state (70.0%). These results are similar to previous studies, [33,38,39] and continue to support the notion that frailty is a dynamic and reversible status in later life [40]. With increasing age, the risk of being frailty and frailty worsening were both higher.…”

Section: Discussionsupporting

confidence: 91%

“…In addition, the decline rate among robust and prefrail female elders was found to be higher than in males. However, after adjusting for lifestyle factors, it seemed that few differences in changes of frailty were consistent with previous studies [18,39]. These findings suggest that females probably have worse health but a more protective lifestyle, which provides a reason for the health-survival paradox.…”

Section: Discussionsupporting

confidence: 88%

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

Chen

Huang

et al. 2020

BMC Geriatr

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Background: It is important to clarify the transitions and related factors of frailty for prevention of frailty. We evaluated the transitions of frailty among community-dwelling older adults and examined the predictors of the transitions. Methods: A cohort study was conducted among 3988 community residents aged ≥60 years during 2015 and 2017. A multiple deficits approach was used to construct the Frailty Index (FI) according to the methodology of FI construction, and sociodemographic characteristics and lifestyles were also collected in 2015. After 2-year follow-up, the transitions of frailty between baseline and were evaluated. Multinomial logistic regressions were used to examine associations between predictors and the transitions of frailty. Results: The proportion of robust, prefrail, and frail was 79.5, 16.4, and 4.1% among 3988 participants at baseline, which changed to 68.2, 23.0, and 8.8% after 2 years with 127 deaths and 23 dropped out. Twelve kinds of transitions from the three frailty statuses at baseline to four outcomes at follow-up (including death) significantly differed within each of gender and age group, as well between genders and age groups. Among these, 7.8% of prefrail or frail elders improved, 70.0% retained their frailty status, and 22.2% of robust or prefrail elders worsened in frailty status. In multivariable models, age was significantly associated with changes in frailty except for in the frail group; higher educational level and working predicted a lower risk of robust worsening. Of the lifestyle predictors, no shower facilities at home predicted a higher risk of robust worsening; more frequent physical exercise predicted a lower risk of robust worsening and a higher chance of frailty improvement; more frequent neighbor interaction predicted a lower risk of robust worsening and prefrail worsening; and more frequent social participation predicted a higher chance of prefrail improvement.

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“…Once identified as pre-frail or frail, it is important to recognize that there exists both a risk of future decline and an opportunity for improvement. 24,25 Sudden, rapid decline although more often seen among those who are frail, is also a risk for those who are pre-frail.…”

Section: Improvement and Maintenance Are Viable Goalsmentioning

confidence: 99%

How best to support individuals with IDD as they become frail: Development of a consensus statement

Ouellette‐Kuntz

Martin

Burke

et al. 2018

Research Intellect Disabil

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Once frail, always frail? Frailty transitions in home care users with intellectual and developmental disabilities

Cited by 12 publications

References 24 publications

Changes in Frailty among Community-Dwelling Older Chinese Adults and its Predictors: Evidence from a Two-Year Longitudinal Study

Changes in Frailty among Community-Dwelling Older Chinese Adults and its Predictors: Evidence from a Two-Year Longitudinal Study

Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study

How best to support individuals with IDD as they become frail: Development of a consensus statement

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