Correlation between Frailty Level and Adverse Health-related Outcomes of Community-Dwelling Elderly, One Year Retrospective Study
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Background: Frailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization,falls, cognitive decline and disability between robust, prefrail and frail elderly in one year. Methods: 110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression,mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago. Results: Among total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54(49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease,depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P <0.005). Conclusion: The frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.
Abstract
Background: Frailty is considered to be a clinical syndrome characterized by decreased physiological reserves associated with a greater risk of health-related problems, hospitalization, and death. The current study examined hospitalization,falls, cognitive decline and disability between robust, prefrail and frail elderly in one year. Methods: 110 participants aged 65 or more who visited two senior welfare centers in Seoul from February 2008 to June 2008were surveyed again from March 2009 to June 2009 with demographic characteristics, number of chronic diseases and medication, study of osteoporotic fractures (SOF) frailty index, instrumental activity of daily living (IADL), depression,mini-mental state examination-Korean version (MMSE-K), falling history and admission history within one year. These results were compared with participants' previous survey done one year ago. Results: Among total 110 subjects, 48 (44%) robust, 30 (27%) prefrail, and 32 (29%) frail subjects changed to 26 (24%), 54(49%), and 30 (27%) respectively over the year. There were statistical significances in age, number of chronic disease,depressive mood, MMSE, falls, hospitalization, IADL disability contributing to frailty (P < 0.05). Frailty defined by SOF frailty index was associated with greater risk of adverse outcomes. Frail subjects had a higher age-adjusted risk of cognitive function decline (odds ratio [OR], 3.57), disability (OR, 9.64), fall (OR, 5.42), and hospitalization (OR, 4.45; P <0.005). Conclusion: The frailty index like SOF frailty index might predict risk of falls, disability, hospitalization, and cognitive decline in the elderly, emphasizing special attention to the individuals showing frailty in outpatient examination.
참고문헌 (30)
- Fried LP, "Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care", J Gerontol A Biol Sci Med Sci, 59, pp.255~263 (2004)
- Freedman VA, "Resolving inconsistencies in trends in old-age disability: report from a technical working group", Demography, 41, pp.417~441 (2004)
- Tinetti ME, "Shared risk factors for falls, incontinence, and functional dependence: unifying the approach to geriatric syndromes", JAMA, 273, pp.1348~1353 (1995)
- Soriano TA, "Falls in the community-dwelling older adult: a review for primary-care providers", Clin Interv Aging, 2, pp.545~554 (2007)
- Boyd CM, "Hospitalization and development of dependence in activities of daily living in a cohort of disabled older women: the Women's Health and Aging Study I", J Gerontol A Biol Sci Med Sci, 60, pp.888~893 (2005)
- Ensrud KE, "Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women", Arch Intern Med, 168, pp.382~389 (2008)
- Ensrud KE, "A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men", J Am Geriatr Soc, 57, pp.492~498 (2009)
- Won JW, "Korea activities of daily living scale and Korea instrumental activities of daily living scale", J Korean Geriatr Soc, 6(s1), pp.93~104 (2002)
- Folstein MF, "Mini-mental state, A practical method for grading the cognitive state of patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
- Kwon YC, "Korean version of mini-mental state examination (MMSE-K) part I: development of the test for the elderly", J Korean Neuropsychiatr Assoc, 28, pp.125~135 (1989)
- Williams-Russo P, "Cognitive effects after epidural vs general anesthesia in older adults: a randomized trial", JAMA, 274, pp.44~50 (1995)
- Hoyl MT, "Development and testing of a fiveitem version of the Geriatric Depression Scale", J Am Geriatr Soc, 47, pp.873~878 (1999)
- Sheikh JI, "Proposed factor structure of the Geriatric Depression Scale", Int Psychogeriatr, 3, pp.23~28 (1991)
- 박현석, "노인 환자에서 다양한 단축형 노인우울척도의 비교", Korean Journal of Family Medicine, 27(5), pp.364~369 (2006), 대한가정의학회
- 마승현, "일부 지역사회 거주 노인들의 노쇠수준과 기능장애의 연관성 및 노쇠 관련요인", Korean Journal of Family Medicine, 30(8), pp.588~597 (2009), 대한가정의학회
- Ravaglia G, "Development of an easy prognostic score for frailty outcomes in the aged", Age Ageing, 37, pp.161~166 (2008)
- Weeks SK, "Comparing various short-form Geriatric Depression Scales leads to the GDS-5", 15, 2003, pp.35, 133~137
- Puts MT, "Static and dynamic measures of frailty predicted decline in performance-based and selfreported physical functioning", J Clin Epidemiol, 58, pp.1188~1198 (2005)
- Mitnitski AB, "The mortality rate as a function of accumulated deficits in a frailty index", Mech Ageing Dev, 123, pp.1457~1460 (2002)
- Puts MT, "What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands", Qual Life Res, 16, pp.263~277 (2007)
- Fried LP, "Frailty in older adults: evidence for a phenotype", J Gerontol A Biol Sci Med Sci, 56, pp.M146~M156 (2001)
- Ensrud KE, "Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women", Arch Intern Med, 168, pp.382~389 (2008)
- Ensrud KE, "Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures", J Gerontol A Biol Sci Med Sci, 62, pp.744~751 (2007)
- Morley JE, "Testosterone and frailty", Clin Geriatr Med, 13, pp.685~695 (1997)
- Iannuzzi-Sucich M, "Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women", J Gerontol A Biol Sci Med Sci, 57, pp.M772~M777 (2002)
- Walston J, "Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study", Arch Intern Med, 162, pp.2333~2341 (2002)
- Leng S, "Serum interleukin-6 and hemoglobin as physiological correlates in the geriatric syndrome of frailty: a pilot study", J Am Geriatr Soc, 50, pp.1268~1271 (2002)
- Shlipak MG, "The presence of frailty in elderly persons with chronic renal insufficiency", Am J Kidney Dis, 43, pp.861~867 (2004)
- Samper-Ternent R, "Relationship between frailty and cognitive decline in older Mexican Americans", J Am Geriatr Soc, 56, pp.1845~1852 (2008)
- Buchman AS, "Frailty is associated with incident Alzheimer's disease and cognitive decline in the elderly", Psychosom Med, 69, pp.483~489 (2007)