Abstract
PurposeTo investigate associations between baseline frailty status and subsequent changes in QOL over time among community-dwelling older people.MethodsAmong 363 community-dwelling older people ≥65 years, frailty was measured using Frailty Index (FI) constructed from 40 deficits at baseline. QOL was measured using Older People’s Quality of Life Questionnaire (OPQOL) six times over 2.5 years. Two-level hierarchical linear models were employed to predict QOL changes over time according to baseline frailty.ResultsAt baseline, mean age was 73.1 (range 65–90) and 62.0 % were women. Mean FI was 0.17 (range 0.00–0.66), and mean OPQOL was 130.80 (range 93–163). The hierarchical linear model adjusted for age, gender, ethnicity, education, and enrollment site predicted that those with higher FI at baseline have lower QOL than those with lower FI (regression coefficient = −47.64, p < 0.0001) and that QOL changes linearly over time with slopes ranging from 0.80 (FI = 0.00) to −1.15 (FI = 0.66) as the FI increases. A FI of 0.27 is the cutoff point at which improvements in QOL over time change to declines in QOL.ConclusionsFrailty was associated with lower QOL among British community-dwelling older people. While less frail participants had higher QOL at baseline and QOL improved over time, QOL of frailer participants was lower at baseline and declined.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-015-1213-2) contains supplementary material, which is available to authorized users.
Highlights
Frailty in older people is a state characterized by vulnerability to poor resolution of homeostasis as a result of agerelated cumulative decline in multiple physiological systems [1]
Frailty was associated with lower quality of life (QOL) among British community-dwelling older people
While less frail participants had higher QOL at baseline and QOL improved over time, QOL of frailer participants was lower at baseline and declined
Summary
Frailty in older people is a state characterized by vulnerability to poor resolution of homeostasis as a result of agerelated cumulative decline in multiple physiological systems [1]. The phenotype criteria were described in the Cardiovascular Health Study by Fried et al [2] and consist of five components: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity, where having 3 or more components is considered as being frail, 1 or 2 as prefrail, and 0 as robust. Another popular approach to operationalize frailty is the Frailty Index (FI). The FI has been shown to predict mortality more accurately than the phenotype in previous cohort studies [7, 8]
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