Prevalence of frailty in older people in Veneto (Italy)*

Abstract

Context: Both frailty and multimorbidity are strong predictors of clinical endpoints for older people. In Italy, the interventions targeting chronicity are mainly based on the treatment of diseases: sufficient epidemiological literature is available about these strategies. Less is known about the territorial distribution of the frailty status.Aims: To estimate the prevalence of frailty in older people (65+) and to evaluate the relationship between frailty and multimorbidity.Methods and material: A group of general practitioners working in Veneto (Italy) was enrolled on a voluntary basis. Older individuals were both community dwelling and institutionalized patients, that is, the older people normally followed by Italian general practitioners. A centrally randomized sample was extracted from the pool of physician-assisted elderly. Each doctor evaluated the frailty status through the CSHA Clinical Frailty Scale and the multimorbidity status through the Charlson score (Frailty = CSHA Clinical Frailty Scale’s score >4; serious multimorbidity = Charlson score ≥4). Prevalence and its confidence interval (CI) 95% were evaluated through the Agresti’s method for proportions. The relation between frailty and multimorbidity was studied through a logistic regression model adjusted for age and sex.Results: Fifty-three physicians were enrolled, whose population of elderly individuals (N = 82919) was highly representative of the population of Veneto. The prevalence of frailty in the randomized sample of 2407 older people was 23.18% (CI 95%: 21.53%–24.91%). Sex was shown to be a strong predictor of frailty (female status OR = 1.58 p < .0001) and multimorbidity was shown to be an independent predictor only for individuals <85 years of age.Conclusions: In Veneto, more than 20% of elderly people are frail. Physicians should pay close attention to frailty and multimorbidity because both are important prognostic factors toward clinical endpoints relevant to territorial care. The CSHA Clinical Frailty Scale (easy and quick) should become part of their professional routine.

The burden of frailty in older people visiting GPs in Veneto and Sicily, Italy

“…Secondary objectives were to compare the prevalence of frailty and multimorbidity in Veneto and Sicily. A third objective was to confirm the relationship between frailty and multimorbidity found in our previous research 17 .…”

“…That research shows that almost one in five elderly in Veneto is affected by frailty, the raw prevalence being 23.18% (21.53–24.91%). In that experience, to be a female acted as a strong and independent risk factor, while age was shown to be a confounder in regards to the multimorbidity: only in elderly individuals aged below 85 year was a significant multimorbidity shown to be an independent predictor of frailty 17 .…”

“…In a previous article we discussed the difficulty in comparing the prevalence of frailty estimated in different settings : this is due to the difference in the analysed populations and the heterogeneity of the diagnostic tools. These factors provide a wide variation in the Italian prevalence of frailty, ranging from 12.7–44.6% 17 .…”

“…By our knowledge our recent cross-sectional study on 2,407 older patients in Veneto 17 is the first Italian experience in which the prevalence of frailty was examined through the CSHA Clinical Frailty Scale 18 in a random sample of the population assisted by general practitioners. That research shows that almost one in five elderly in Veneto is affected by frailty, the raw prevalence being 23.18% (21.53–24.91%).…”

Frailty and Quality Of Life in the Elderly Living in Nursing Home

“…Also, it was found that the frailty scores of women were higher, but was not significantly correlated with the quality of life (Table 1). Previous studies suggest that frailty is more common in females than in males, however, the reason for this difference has not been elucidated, and female sex was included among the criteria for successful description of frailty (30,31). These results have indicated that the necessity of determining frailty in female elderly individuals and planning the care by considering risk factors is important.…”