Prevalence, transitions and factors predicting transition between frailty states among rural community-dwelling older adults in Malaysia.

Nur Sakinah Ahmad,Mas Ayu Said,Noran Naqiah Hairi,Devi Peramalah,Norliana Ismail,Shathanapriya Kandiben,Shahrul Bahyah Kamaruzzaman,Inayah Abdul Razak,Wan Yuen Choo,Zainudin Mohd Ali,Sharifah Nor Ahmad,Sajaratulnisah Othman,Awang Bulgiba,Farizah Hairi,Alessandra Marengoni

doi:10.1371/journal.pone.0206445

Nur Sakinah Ahmad, Mas Ayu Said + Show 13 more

Open Access

https://doi.org/10.1371/journal.pone.0206445

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Journal: PloS one	Publication Date: Nov 5, 2018
Citations: 42	License type: CC BY 4.0

Affiliation: University of Malaya, Malaysia Theological Seminary

Abstract

ObjectivesThis study aims to describe the prevalence and transitions of frailty among rural-community dwelling older adults in Malaysia and to analyse factors associated with different states of frailty transition. Frailty was conceptualized using modified Fried phenotype from the Cardiovascular Health Study.DesignThis is a prospective longitudinal study with 12-months follow up among older adults in Malaysia.SettingKuala Pilah, a district in Negeri Sembilan, which is one of the fourteen states in Malaysia.Participants2,324 community-dwelling older Malaysians aged 60 years and older.ResultsThe overall prevalence of frailty in this study was 9.4% (95% CI 7.8–11.2). The prevalence increased at least three-fold with every 10 years of age. This increase was seen higher in women compared to men. Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p<0.05). During the 12-months follow-up, our study showed that the transition towards greater frailty states were more likely (22.9%) than transition toward lesser frailty states (19.9%) while majority (57.2%) remained unchanged. Multivariate logistic regression analysis showed that presence of low physical activity increased the likelihood of worsening transition towards greater frailty states by three times (OR 2.9, 95% CI 2.2–3.7) and lowered the likelihood of transition towards lesser frailty states (OR 0.3, 95% CI 0.2–0.4).ConclusionFrailty is reported among one in every eleven older adults in this study. The prevalence increased across age groups and was higher among women than men. Frailty possesses a dynamic status due to its potential reversibility. This reversibility makes it a cornerstone to delay frailty progression. Our study noted that physical activity conferred the greatest benefit as a modifiable factor in frailty prevention.

Highlights

An ageing population is a universal phenomenon experienced by all countries in the world [1]
Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p
During the 12-months follow-up, our study showed that the transition towards greater frailty states were more likely (22.9%) than transition toward lesser

Summary

Introduction

An ageing population is a universal phenomenon experienced by all countries in the world [1]. Occurring at different paces in different settings, this demographic transition increases the number of older adults in most countries [2] This transition has profound implications as an ageing population is associated with functional decline which leads to higher dependency. The presence of frailty among older adults indicates multisystem dysregulation resulting in decreased adaptability and loss of homeostatic mechanisms [7, 8]. These processes comprise the capacity to withstand environmental stresses and expose these older adults to an increased risk of adverse outcomes [9,10,11]. Given that the consequences of cumulative decline involve multiple physiological systems, frailty has been recognised as the most problematic expression of an ageing population [3]

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