Risk Factors of Progression to Frailty: Findings from the Singapore Longitudinal Ageing Study

Cheong, Chin Yee; Nyunt, Ma Shwe Zin; Gao, Qi; Gwee, Xinyi; Choo, Robin; Yap, Keng Bee; Wee, Shiou Liang; Ng, Tze‐Pin

doi:10.1007/s12603-019-1277-8

Cited by 30 publications

(25 citation statements)

References 49 publications

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“…Brunner et al, 2018 21 Cheong et al, 2019 22 Chhetri et al, 2017 23 Doi et al, 2018 24 Espinoza et al, 2010 25 Garcia-Esquinas et al, 2015 26 Raji et al, 2010 27 Woods et al…”

Section: Author Yearmentioning

confidence: 99%

Frailty measurement, prevalence, incidence, and clinical implications in people with diabetes: a systematic review and study-level meta-analysis

Hanlon

Fauré

Corcoran

et al. 2020

The Lancet Healthy Longevity

107

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Background Frailty, a state of increased vulnerability to adverse health outcomes, is important in diabetes management. We aimed to quantify the prevalence of frailty in people with diabetes, and to summarise the association between frailty and generic outcomes (eg, mortality) and diabetes-specific outcomes (eg, hypoglycaemia). Methods In this systematic review and study-level meta-analysis, we searched MEDLINE, Embase, and Web of Science for observational studies published between Jan 1, 2001 (the year of the original publication of the Fried frailty phenotype), to Nov 26, 2019. We included studies that assessed and quantified frailty in adults with diabetes, aged 18 years and older; and excluded conference abstracts, grey literature, and studies not published in English. Data from eligible studies were extracted using a piloted data extraction form. Our primary outcome was the prevalence of frailty in people with diabetes. Secondary outcomes were incidence of frailty and generic and diabetes-specific outcomes. Data were assessed by random-effects meta-analysis where possible and by narrative synthesis where populations were too heterogeneous to allow meta-analysis. This study is registered with PROSPERO, CRD42020163109. Findings Of the 3038 studies we identified, 118 studies using 20 different frailty measures were eligible for inclusion (n=1 375 373). The most commonly used measures of frailty were the frailty phenotype (69 [58%] of 118 studies), frailty (16 [14%]), and FRAIL scale (10 [8%]). Studies were heterogenous in setting (88 studies were community-based, 18 were outpatient-based, ten were inpatient-based, and two were based in residential care facilities), demographics, and inclusion criteria; therefore, we could not do a meta-analysis for the primary outcome and instead summarised prevalence data using a narrative synthesis. Median community frailty prevalence using frailty phenotype was 13% (IQR 9-21). Frailty was consistently associated with mortality in 13 (93%) of 14 studies assessing this outcome (pooled hazard ratio 1•51 [95% CI 1•30-1•76]), with hospital admission in seven (100%) of seven, and with disability in five (100%) of five studies. Frailty was associated with hypoglycaemia events in one study (<1%), microvascular and macrovascular complications in nine (82%) of 11 studies assessing complications, lower quality of life in three (100%) of three studies assessing quality of life, and cognitive impairment in three (100%) of three studies assessing cognitive impairment. 13 (11%) of 118 studies assessed glycated haemoglobin finding no consistent relationship with frailty. Interpretation The identification and assessment of frailty should become a routine aspect of diabetes care. The relationship between frailty and glycaemia, and the effect of frailty in specific groups (eg, middle-aged [aged <65 years] people and people in low-income and lower-middle-income countries) needs to be better understood to enable diabetes guidelines to be tailored to individuals with frailty. Funding Medical Rese...

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“…Brunner et al, 2018 21 Cheong et al, 2019 22 Chhetri et al, 2017 23 Doi et al, 2018 24 Espinoza et al, 2010 25 Garcia-Esquinas et al, 2015 26 Raji et al, 2010 27 Woods et al…”

Section: Author Yearmentioning

confidence: 99%

Frailty measurement, prevalence, incidence, and clinical implications in people with diabetes: a systematic review and study-level meta-analysis

Hanlon

Fauré

Corcoran

et al. 2020

The Lancet Healthy Longevity

107

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“…in the pre-frail stage [32], but indicated a signi cantly higher percentage of frail older adults compared to another study in Greece, where 1.5% of older adults were in the frail stage [16]. According to previous studies, the percentage of transition from pre-frail to frail is high [33]. It is crucial to provide interventions that prevent the transition between stages of frailty, especially by identifying factors in uencing the transition from the prefrail to the frail stage.…”

Section: Discussionmentioning

confidence: 72%

Factors Influencing the Stages of Frailty among Korean Older Adults Focusing on Objective and Subjective Social Isolation

Han

Jang

2021

Preprint

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Background: Although many studies have investigated the factors influencing frailty, studies on factors affecting transition between frailty stages are insufficient. This study was conducted to identify factors influencing the stages of frailty in Korean older adults, focusing on objective and subjective social isolation. Methods: This study analyzed the data of 10,041 older adults from the 2017 National Survey of Older Koreans. Two multiple logistic regression analyses were performed to identify the factors influencing the frailty stages.Results: Among Korean older adults, 6% were in a frail stage, and 42.5% were in the pre-frail stage. The progression to the pre-frail stage was influenced by sociodemographic and health-related characteristics and by objective and subjective social isolation. Contrastingly, the transition from the pre-frail to frail stage was influenced by factors including objective social isolation, declining hearing, and lack of regular exercise.Conclusions: In the development of future interventions, researchers should consider differences in factors that influence the stages of frailty among Korean older adults. Interventions that help older people maintain existing social relationships or connect to new social networks can delay the transition from the pre-frail to frail stages.

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“…Our findings are compatible with some other studies in the region. In the Singapore Longitudinal Ageing Study 2 on 1297 older community-dwellers, older age was one of the significant predictors for frailty transition (defined by the frailty phenotype) after 3-5 years [12]. In another study in Indonesia, older age, low quality of life, and slow gait speed were prognostic factors for frailty transition (defined by the Frailty Index) after 12 months [13].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

Nguyen

2020

IJERPH

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Background. The Clinical Frailty Scale (CFS) is gaining increasing acceptance due to its simplicity and applicability. Aims. This pilot study aims to examine the role of CFS in identifying the prevalence of frailty, frailty transition, and the impact of frailty on readmission after discharge in older hospitalized patients. Methods. Patients aged ≥60 admitted to the geriatric ward of a hospital in Vietnam were recruited from 9/2018-3/2019 and followed for three months. Frailty was assessed before discharge and after three months, using the CFS (robust: score 1-2, pre-frail: 3-4, and frail: ≥5). Multivariate logistic regression was applied to investigate the associated factors of frailty transition and the impact of frailty on readmission. Results. There were 364 participants, mean age 74.9, 58.2% female. At discharge, 4 were robust, 160 pre-frail, 200 frail. Among the 160 pre-frail participants at discharge, 124 (77.5%) remained pre-frail, and 36 (22.5%) became frail after 3 months. Age (adjusted OR1.09, 95% CI 1.03-1.16), number of chronic diseases (adjusted OR 1.37, 95% CI 1.03-1.82), and polypharmacy at discharge (adjusted OR 3.68, 95% CI 1.15-11.76) were significant predictors for frailty after 3 months. A frailty status at discharge was significantly associated with increased risk of readmission (adjusted OR2.87, 95% CI 1.71-4.82). Conclusions. Frailty was present in half of the participants and associated with increased risk of readmission. This study suggests further studies to explore the use of the CFS via phone calls for monitoring patients' frailty status after discharge, which may be helpful for older patients living in rural and remote areas.

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Risk Factors of Progression to Frailty: Findings from the Singapore Longitudinal Ageing Study

Cited by 30 publications

References 49 publications

Frailty measurement, prevalence, incidence, and clinical implications in people with diabetes: a systematic review and study-level meta-analysis

Frailty measurement, prevalence, incidence, and clinical implications in people with diabetes: a systematic review and study-level meta-analysis

Factors Influencing the Stages of Frailty among Korean Older Adults Focusing on Objective and Subjective Social Isolation

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

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