Abstract
The objectives of this study were to compare how different frailty measures (Frailty Phenotype/FP, Groningen Frailty Indicator/GFI and Tilburg Frailty Indicator/TFI) predict short-term adverse outcomes. Secondarily, adopting a multidimensional approach to frailty (integral conceptual model–TFI), this study aims to compare how physical, psychological and social frailty predict the outcomes. A longitudinal study was carried out with 95 community-dwelling elderly. Participants were assessed at baseline for frailty, determinants of frailty, and adverse outcomes (healthcare utilization, quality of life, disability in basic and instrumental activities of daily living/ADL and IADL). Ten months later the outcomes were assessed again. Frailty was associated with specific healthcare utilization indicators: the FP with a greater utilization of informal care; GFI with an increased contact with healthcare professionals; and TFI with a higher amount of contacts with a general practitioner. After controlling for the effect of life-course determinants, comorbidity and adverse outcome at baseline, GFI predicted IADL disability and TFI predicted quality of life. The effect of the FP on the outcomes was not significant, when compared with the other measures. However, when comparing TFI’s domains, the physical domain was the most significant predictor of the outcomes, even explaining part of the variance of ADL disability. Frailty at baseline was associated with adverse outcomes at follow-up. However, the relationship of each frailty measure (FP, GFI and TFI) with the outcomes was different. In spite of the role of psychological frailty, TFI’s physical domain was the determinant factor for predicting disability and most of the quality of life.
Highlights
As the number of elderly people increases worldwide, so does the prevalence of frailty (Clegg et al, 2013; Collard et al, 2012)
The assessment based on the presence of the components that make up the Frailty Phenotype/FP (Fried et al, 2001) has gained wide attention in the scientific community (Bouillon et al, 2013; Cesari et al, 2014; Rodriguez-Manas et al, 2013; Sternberg et al, 2011)
The individuals were assessed for life-course determinants of frailty, comorbidity, frailty and adverse outcomes
Summary
As the number of elderly people increases worldwide, so does the prevalence of frailty (Clegg et al, 2013; Collard et al, 2012). The assessment based on the presence of the components that make up the Frailty Phenotype/FP (Fried et al, 2001) (unintentional weight loss, low physical activity, exhaustion, slow walking speed and weakness) has gained wide attention in the scientific community (Bouillon et al, 2013; Cesari et al, 2014; Rodriguez-Manas et al, 2013; Sternberg et al, 2011) This approach stems from a biological model, in which frailty is defined as an exclusively physical condition, caused by energy dysregulation and functional decline across multiple physiological systems (Fried et al, 2001; Fried, Walston & Ferrucci, 2009)
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