Frailty syndrome diagnosed according to the Study of Osteoporotic Fractures (SOF) criteria and adverse health outcomes among community-dwelling older outpatients in Italy. A one-year prospective cohort study

Abstract

The easy-to-apply SOF criteria for frailty were recently validated in studies conducted in the U.S. only. In order to determine the ability of the SOF criteria to predict adverse health outcomes at a one-year follow-up in a sample of older outpatients in Italy we carried out a prospective cohort study on 265 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric clinic. At baseline participants underwent a comprehensive geriatric assessment (CGA) including evaluation of their frailty status according to the SOF criteria. At a one-year follow-up, between June and December 2010, we investigated nursing home placement and death in all participants as well as any fall, any admission to the emergency department (ED), any hospitalization and a greater disability among the subset of subjects still living at home. One year after the visit 231 subjects were still living at home (87.2%), 9 had been placed in a nursing home (3.4%) and 25 had died (9.4%). Frailty was associated with a greater risk of falls (odds ratio [OR] 2.01, 95% confidence interval [CI] 1.05–3.83, p=0.035), hospitalization (OR 2.08, 95% CI 1.02–4.24, p=0.045) and death (OR 3.07, 95% 1.02–4.24, p=0.045) after correction for demographic characteristics, comorbidity including dementia and depression, socioeconomic position and severe disability. Thus, in an older outpatient population in Italy the frailty syndrome diagnosed according to the SOF criteria was an independent predictor of several adverse health outcomes.