Frailty in INstitutionalized older adults from ALbacete. The FINAL Study: rationale, design, methodology, prevalence and attributes

Maturitas. 2014 Jan;77(1):78-84. doi: 10.1016/j.maturitas.2013.10.005. Epub 2013 Oct 16.

Abstract

Background: Little is known about frailty in institutionalized older adults, and there are few longitudinal studies on this topic.

Objectives: To determine the prevalence and attributes of frailty in institutionalized Spanish older adults.

Design: Cross-sectional analysis of basal data of a concurrent cohort study.

Setting: Two nursing homes, Vasco Núñez de Balboa and Paseo de la Cuba, in Albacete, Spain.

Participants: 331 institutionalized adults older than 65 years.

Measurements: Frailty was defined by the presence of 3 or more Fried criteria and prefrailty by the presence of 1 or 2: unintentional weight loss, low energy, exhaustion, slowness, and low physical activity. Covariables were sociodemographic, anthropometric, functional, cognitive, affective and of comorbidity. Hospitalization, emergency visits and falls in the 6 previous months was recorded. Differences between non-frail and prefrail as one group and frail participants were analyzed using χ(2) tests, t-Student and logistic regression.

Results: Mean age 84.1 (SD 6.7), with 209 (65.1%) women. 68.8% were frail, 28.4% pre-frail, 2.8% non-frail, and in 2.2% three criteria were not available to determine frailty status. Women were more frequently frail than men (77.1% vs. 22.9%; p<0.001), and frail participants were older (85.1 vs. 82.3; p<0.001) than non-frail ones. Female sex (OR 2.7 95%CI 1.2-6.2), Barthel index (OR 2.2 95%CI 1.2-4.4), depression risk (OR 2.2 95%CI 1.0-4.9) and Short Physical Performance Battery scores (0.7 95%CI 0.6-0.8) were independently associated with frailty status. Frailty had a non-significant association with hospitalization (OR 1.9 95%CI 0.8-4.5) and emergency visits (OR 1.5 95%CI 0.7-3.2) in the previous 6 months.

Conclusion: In a cohort of institutionalized older adults the prevalence of frailty was 68.8% and was associated with adverse health geriatric outcomes.

Keywords: Design; Frail elderly; Institutionalization; Nursing home; Prevalence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cross-Sectional Studies
  • Depression* / etiology
  • Emergency Service, Hospital
  • Fatigue
  • Female
  • Frail Elderly* / psychology
  • Frail Elderly* / statistics & numerical data
  • Geriatric Assessment*
  • Hospitalization
  • Humans
  • Institutionalization*
  • Male
  • Odds Ratio
  • Prevalence
  • Sex Factors
  • Spain
  • Weight Loss