Associations between Frailty, Complex Care Needs and Quality of Life in Multi-Morbid Older People.

Abstract

Little is known regarding the complex care needs, level of frailty or quality of life of multi-morbid older patients. The objective of this study was to determine the relationship between frailty, complexity of care and quality of life in multi-morbid older people. Cross-sectional study. Thirteen primary care practices in the Netherlands. 1,150 multi-morbid older people living in the community. The level of frailty was assessed with the Groningen Frailty Indicator. Complexity of care needs was measured with the Intermed for the Elderly Self-Assessment. Quality of life (QoL) was measured with two items of the RAND-36. In total, 758 out of 1,150 (65.9%) patients were frail, 8.3% had complex care needs, and the mean QoL score was 7.1 (standard deviation 1.2). Correlations between frailty and complexity, frailty and QoL, and complexity of care and QoL were 0.67, -0.51 and -0.52 (all p<0.001) respectively. All patients with complex care needs were frail, but, only 12.5% of the frail patients had complex care needs. Problems at climbing up stairs was associated with higher levels of frailty and complexity of care but with a lower QoL. Higher levels of frailty and complexity of care are associated with a lower QoL in multi-morbid older people. The results of this study contribute to a better understanding these concepts and are valuable for the development of tailored interventions for older persons in the future.