Lahousse L, Maes B, Ziere G, et al.
Eur J Epidemiol 2014;29:419-27
Publication date: June 1, 2014
Given the expanding elderly population and the major impact of population aging on health and social care, the identification of frail people among older adults has become of increasing interest. The authors investigated the prevalence of physical frailty in a Dutch population-based cohort and evaluated its impact on adverse health outcomes independent of comorbidities over a 3-year period.
Frailty was assessed using the physical definition of frailty developed in the Cardiovascular Health Study and defined as meeting three or more of the five established frailty criteria: weight loss, low physical activity, slow walking speed mobility, weak grip strength and exhaustion. Intermediate frailty was defined as meeting one or two of those criteria. Comorbidities were objectively measured.
Of 2833 assessed individuals (71.6% of the 4027 study participants who recently visited the research center) aged 55 years or older, 5.8% were frail and 51.3% were intermediate frail. Frail participants were more likely to be older and female. The proportion of individuals with two or more comorbidities was 72.0% among frail individuals compared with 44.8 among non-frail study participants.
Frail individuals were more likely to have fallen or to have been hospitalized in the previous year. Frailty was associated with a significantly impaired quality of life. During the 3-year follow-up period, mortality was 16.0%, 4.3% and 2.4% among frail, intermediate frail and non-frail persons, respectively (P < 0.001). After adjustment for age, sex and comorbidity, frailty was associated with a more than threefold increased risk of death (hazard ratio 3.43; P < 0.001).