FRAILTY AS A DYNAMIC GERIATRIC SYNDROME: ANALYSIS OF THE RISK FACTORS FOR THE ONSET OF FRAILTY USING THE SHARE DATABASE

Abstract

Frailty is an age-related multifactorial syndrome that has profound implications on planning and delivering healthcare and social assistance. Using the Survey of Health, Ageing and Retirement in Europe (SHARE) we derived a database with individuals interviewed in both Wave 4 (2011) and Wave 6 (2015), and we aimed to investigate factors associated with frailty. We considered a population of 10,432 community-dwelling subjects aged ≥65. The collected data included a comprehensive assessment with which we derived the 5 criteria of Fried’s operative definition for frailty: unintentional weight loss, fatigue, muscular weakness, gait slowness, low physical activity. Individuals are frail with ≥3 positive criteria, pre-frail with 1–2 criteria, and fit with no criteria. We assessed the prevalence of pre-frailty and frailty in both waves and we analyzed the factors potentially associated with developing frailty at Wave 6 (primary outcome). We found 4,438 fit, 4,834 pre-frail and 1,160 frail subjects at Wave 4. The number of pre-frail (n=5,216) and frail subjects (n=2,008) increased at Wave 6. Using multivariate logistic regression analyses, we showed that male gender (OR 1.52, 95% C.I.: 1.21–1.91), being underweight (OR 3.23, 95% C.I.: 1.93–5.41) and suffering from diabetes (OR 2.34, 95% C.I.: 1.75–3.11) were independent risk factors for the outcome. Conversely, being engaged in indoor (reading, board games) or outdoor activities (charities, clubs, political/religious initiatives) were protective against developing frailty. Recognizing the modifiable risk factors for frailty and promoting an active/engaging lifestyle will potentially allow to reduce the burden of this syndrome on an aging population.