Frailty Phenotype: Evidence of Both Physical and Mental Health Components in Community-Dwelling Early-Old Adults
Received 13 November 2019
Accepted for publication 27 December 2019
Published 5 February 2020 Volume 2020:15 Pages 141—150
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Walker
Agnieszka Batko-Szwaczka,1 Joanna Dudzińska-Griszek,1 Beata Hornik,2 Magdalena Janusz-Jenczeń,2 Iwona Włodarczyk,2 Bartosz Wnuk,3 Joanna Szołtysek,3 Jacek Durmała,3 Krzysztof Wilczyński,1 Anna Cogiel,1 Jan Dulawa,4 Jan Szewieczek1
1Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 2Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 3Department of Rehabilitation, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 4Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Correspondence: Jan Szewieczek
Department of Geriatrics, GCM, Ul. Ziolowa 45/47, Katowice 40-635, Poland
Background: Demographic aging results in increased incidence of old-age disability. Frailty is a major factor contributing to old-age disability. The aim of this study was to investigate the prevalence of the frailty phenotype as defined by Fried et al and to estimate the need for associated preventative interventions in early-old community-dwelling inhabitants of the southern industrial region of Poland, as well as to investigate the defining components of the frailty phenotype.
Methods: The study group consisted of 160 individuals with an average age of 66.8 ± 4.2 years ( ± SD), 71 (44.4%) of study participants were women. The cohort was randomized out of over 843 thousand community-dwelling Upper Silesian inhabitants aged 60– 74 years, who agreed to participate in this project. A comprehensive geriatric assessment (CGA), frailty phenotype test (as described by Fried et al) blood tests and bioimpedance body structure analysis was completed for study participants. Functional assessment included Barthel Index of Activities of Daily Living (Barthel Index), Instrumental Activities of Daily Living Scale (IADL), Mini-Mental State Examination (MMSE), the Timed Up and Go (TUG) test, Tinetti Performance-Oriented Mobility Assessment (POMA), and Geriatric Depression Scale – Short Form (GDS-SF).
Results: Prefrailty was diagnosed in 24.4% of the subjects (95% Confidence Interval (CI) = 17.7– 31.0%; 31% in women and 19.1% in men, P=0.082) and frailty in 2.5% subjects (95% CI 0.1– 4.9%; more frequently in women: 4.2% versus 1.1% in men, P=0.046). Having one or more positive frailty criteria was positively associated with depression (odds ratio (OR)=2.85, 95% CI=1.08– 7.54, P=0.035) and negatively associated with MMSE score (OR=0.72, 95% CI=0.56– 0.93, P=0.012) and fat-free mass (OR=0.96, 95% CI=0.92– 0.99, P=0.016) in multivariate logistic regression analysis adjusted for age, sex, disease prevalence, number of medications, functional tests (Barthel Index, IADL, MMSE, GDS-SF), BMI, bioimpedance body composition score, and blood tests.
Conclusion: At least 25% of the early-old community-dwelling population would benefit from a frailty prevention program. The frailty phenotype reflects both physical and mental health in this population.
Keywords: frailty phenotype, early-old community-dwelling population, cognitive function, depression, disability, comprehensive geriatric assessment
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