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Current Aging Science

Editor-in-Chief

ISSN (Print): 1874-6098
ISSN (Online): 1874-6128

Research Article

Prediction of Risk of Frailty Among Institutionalized Older Adults in India

Author(s): Nisha Kulal, Girish Nandakumar* and Vaishali K

Volume 16, Issue 1, 2023

Published on: 28 September, 2022

Page: [33 - 39] Pages: 7

DOI: 10.2174/1874609815666220415130737

Price: $65

Abstract

Background: Frailty is a state of age-related physiological vulnerability resulting from impaired homeostatic reserve and a reduced capacity of the individual to withstand stress and an independent predictor of deleterious health outcomes among the aged. Early identification of people who are at risk for frailty is vital in preventing and minimizing its socio-economic consequences in low-resource countries like India. However, risk factors for frailty among Indian institutionalized older adults have been seldom explored.

Objective: The objective of this study is to develop a prediction model for the risk of frailty among institutionalized older adults.

Methods: This study adopted a case-control design, wherein institutionalized adults were categorized into frail and non-frail, using Fried’s criteria. Individuals above 55 years of age who could follow instructions without severe motor and cognitive impairment and terminal illness were recruited from nine conveniently selected institutions. Socio-demographic, lifestyle, behavioral, and physical performance factors were evaluated by including hundred participants.

Results: Among the fourteen independent variables, age, cognition, income, functional mobility, polypharmacy and presence of more than 3 comorbidities were significant in univariate analysis. But adjusted odds ratio showed a statistical significance for low educational status, low income, poor functional mobility, and presence of more than 3 co-morbidities only, hence they were used for developing the prediction model.

Conclusion: Low education status, low income, poor functional mobility, and presence of more than 3 comorbidities were found to have a significant association with the risk of frailty. A model has been developed to predict the risk and early identification of frailty among institutionalized older adults.

Keywords: Case-Control studies, Frail elderly, Frailty, Odds Ratio, Physical functional performance

[1]
Fried LP, Tangen CM, Walston J. et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146-56.
[http://dx.doi.org/10.1093/gerona/56.3.M146] [PMID: 11253156]
[2]
Chen X, Mao G, Leng SX. Frailty syndrome: An overview. Clin Interv Aging 2014; 9: 433-41.
[PMID: 24672230]
[3]
Fulop T, Larbi A, Witkowski JM. et al. Aging, frailty and age-related diseases. Biogerontology 2010; 11(5): 547-63.
[http://dx.doi.org/10.1007/s10522-010-9287-2] [PMID: 20559726]
[4]
Rodríguez-Mañas L, Féart C, Mann G. et al. Searching for an operational definition of frailty: A Delphi method based consensus state-ment: The frailty operative definition-consensus conference project. J Gerontol A Biol Sci Med Sci 2013; 68(1): 62-7.
[http://dx.doi.org/10.1093/gerona/gls119] [PMID: 22511289]
[5]
Bouillon K, Kivimaki M, Hamer M. et al. Measures of frailty in population-based studies: An overview. BMC Geriatr 2013; 13(1): 64.
[http://dx.doi.org/10.1186/1471-2318-13-64] [PMID: 23786540]
[6]
Feng Z, Lugtenberg M, Franse C. et al. Risk factors and protective factors associated with incident or increase of frailty among communitydwelling older adults: A systematic review of longitudinal studies. PLoS One 2017; 12(6)e0178383
[http://dx.doi.org/10.1371/journal.pone.0178383] [PMID: 28617837]
[7]
Kashikar Y, Nagarkar A. Prevalence and determinants of frailty in older adults in India. Indian J Gerontol 2016; 30(3): 364-81.
[8]
Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR. Prevalence of frailty and prefrailty among communitydwelling older adults in low-income and middle-income countries: A systematic review and meta-analysis. BMJ Open 2018; 8(3)e018195
[http://dx.doi.org/10.1136/bmjopen-2017-018195] [PMID: 29496895]
[9]
Kojima G. Prevalence of frailty in nursing homes: A systematic review and meta-analysis. J Am Med Dir Assoc 2015; 16(11): 940-5.
[http://dx.doi.org/10.1016/j.jamda.2015.06.025] [PMID: 26255709]
[10]
Rockwood K, Stolee P, McDowell I. Factors associated with institutionalization of older people in Canada: Testing a multifactorial defini-tion of frailty. J Am Geriatr Soc 1996; 44(5): 578-82.
[http://dx.doi.org/10.1111/j.1532-5415.1996.tb01446.x] [PMID: 8617909]
[11]
Travers J, Romero-Ortuno R, Bailey J, Cooney MT. Delaying and reversing frailty: A systematic review of primary care interventions. Br J Gen Pract 2019; 69(678): e61-9.
[http://dx.doi.org/10.3399/bjgp18X700241] [PMID: 30510094]
[12]
Groll DL, To T, Bombardier C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol 2005; 58(6): 595-602.
[http://dx.doi.org/10.1016/j.jclinepi.2004.10.018] [PMID: 15878473]
[13]
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist. Aging Ment Health 1986; 5(1-2): 165-73.
[14]
Nasreddine ZS, Phillips NA, Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695-9.
[http://dx.doi.org/10.1111/j.1532-5415.2005.53221.x] [PMID: 15817019]
[15]
Bohannon RW. Reference values for the timed up and go test: A descriptive meta-analysis. J Geriatr Phys Ther 2006; 29(2): 64-8.
[http://dx.doi.org/10.1519/00139143-200608000-00004] [PMID: 16914068]
[16]
Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: Reference values and determinants. Age Ageing 1997; 26(1): 15-9.
[http://dx.doi.org/10.1093/ageing/26.1.15] [PMID: 9143432]
[17]
Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis 2006; 3(4): A118.
[PMID: 16978493]
[18]
Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1(3): 385-401.
[http://dx.doi.org/10.1177/014662167700100306]
[19]
Vetrano DL, Palmer K, Marengoni A. et al. Frailty and Multimorbidity: A systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci 2019; 74(5): 659-66.
[http://dx.doi.org/10.1093/gerona/gly110] [PMID: 29726918]
[20]
Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: A prospective analysis of 493 737 UK Biobank participants. Lancet Public Health 2018; 3(7): e323-32.
[http://dx.doi.org/10.1016/S2468-2667(18)30091-4] [PMID: 29908859]
[21]
Volkert D. Nutrition and frailty. What the elderly should eat. MMW Fortschr Med 2012; 154(10): 45-8.
[http://dx.doi.org/10.1007/s15006-012-0695-x]
[22]
Witham MD, Davies JI, Bärnighausen T. et al. Frailty and physical performance in the context of extreme poverty: A population-based study of older adults in rural Burkina Faso. Wellcome Open Res 2019; 4: 135.
[http://dx.doi.org/10.12688/wellcomeopenres.15455.1] [PMID: 32280791]
[23]
Walters K, Frost R, Kharicha K. et al. Home-based health promotion for older people with mild frailty: The HomeHealth intervention de-velopment and feasibility RCT. Health Technol Assess 2017; 21(73): 1-128.
[http://dx.doi.org/10.3310/hta21730] [PMID: 29214975]
[24]
Kim H, Awata S, Watanabe Y. et al. Cognitive frailty in community-dwelling older Japanese people: Prevalence and its association with falls. Geriatr Gerontol Int 2019; 19(7): 647-53.
[http://dx.doi.org/10.1111/ggi.13685] [PMID: 31083795]
[25]
Savva GM, Donoghue OA, Horgan F, O’Regan C, Cronin H, Kenny RA. Using timed up-and-go to identify frail members of the older population. J Gerontol A Biol Sci Med Sci 2013; 68(4): 441-6.
[http://dx.doi.org/10.1093/gerona/gls190] [PMID: 22987796]
[26]
Majid Z, Welch C, Davies J, Jackson T. Global frailty: The role of ethnicity, migration and socioeconomic factors. Maturitas 2020; 139: 33-41.
[http://dx.doi.org/10.1016/j.maturitas.2020.05.010] [PMID: 32747038]
[27]
Hoogendijk EO, Rijnhart JJM, Kowal P. et al. Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: Results from the WHO Study on global AGEing and adult health (SAGE). Maturitas 2018; 115: 56-63.
[http://dx.doi.org/10.1016/j.maturitas.2018.06.011] [PMID: 30049348]
[28]
Diez-Ruiz A, Bueno-Errandonea A, Nuñez-Barrio J, Sanchez-Martín I, Vrotsou K, Vergara I. Factors associated with frailty in primary care: A prospective cohort study. BMC Geriatr 2016; 16: 91.
[http://dx.doi.org/10.1186/s12877-016-0263-9] [PMID: 27126440]
[29]
Vieira de SJA, Lenardt MH, Grden CRB, Kusomota L, Dellaroza MSG, Betiolli SE. Physical frailty prediction model for the oldest old. Rev Lat Am Enfermagem 2018; 26: e3023.
[http://dx.doi.org/10.1590/1518-8345.2346.3023]

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