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• Re: Association between frailty and disability in rural community-dwelling older adults
  Ashara Y McQueen
  Published on: 6 December 2020
• Association between frailty and disability in rural community-dwelling older adults
  Tomoyuki Kawada
  Published on: 16 November 2020

• Published on: 6 December 2020

  Re: Association between frailty and disability in rural community-dwelling older adults

  • Ashara Y McQueen, Nursing Student The University of The Bahamas

  Ashara McQueen, Nursing Student, The University of The Bahamas
  As it relates to the above mentioned article that was published on March 29th 2020 in Volume10, Issue 3 on BMJ Open. I found that this was a very interesting article as it relates to age related changes of older adults, that will most definitely spark the interest of those involved in gerontology and geriatric research. As I read this article, it is evident that frailty can be associated with disability among dwelling older adults. I agree with the author that although frailty and disability may intertwine thus their concepts are absolutely different. This judgement can simply be gathered based on the definitions that were provided and stated explicitly as it relates to the term’s frailty and disability. However, there are factors that are strongly associated with frailty and disability such as socioeconomic status, ethnicity and life style.
  Furthermore, the results from this study shows the prevalence of more than half of the percentage of older frail adults displayed greater instrumental activities of daily living (IADL) while the remaining smaller percentage displayed greater basic activities of daily living (BADL). In addition, high count of IADL limitations were associated with being frail.
  Other authors conducted a study on prevalence of frailty among dwelling older adults and their sociodemographic factors associated with frailty. Kendhapedi and Devasenapathy (2019), found a high sign...

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  Ashara McQueen, Nursing Student, The University of The Bahamas
  As it relates to the above mentioned article that was published on March 29th 2020 in Volume10, Issue 3 on BMJ Open. I found that this was a very interesting article as it relates to age related changes of older adults, that will most definitely spark the interest of those involved in gerontology and geriatric research. As I read this article, it is evident that frailty can be associated with disability among dwelling older adults. I agree with the author that although frailty and disability may intertwine thus their concepts are absolutely different. This judgement can simply be gathered based on the definitions that were provided and stated explicitly as it relates to the term’s frailty and disability. However, there are factors that are strongly associated with frailty and disability such as socioeconomic status, ethnicity and life style.
  Furthermore, the results from this study shows the prevalence of more than half of the percentage of older frail adults displayed greater instrumental activities of daily living (IADL) while the remaining smaller percentage displayed greater basic activities of daily living (BADL). In addition, high count of IADL limitations were associated with being frail.
  Other authors conducted a study on prevalence of frailty among dwelling older adults and their sociodemographic factors associated with frailty. Kendhapedi and Devasenapathy (2019), found a high significant rate of fear of falling and falling associated with frailty among older people. Furthermore, South India prevalence of frailty among older people were high when compared to low-income and middle-income countries. The authors in this article also investigated the prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries. Siriwardhana et al. (2018), found that prevalence of frailty and prefrailty were higher in community-dwelling older adults in upper middle-income countries in comparison with high income countries among dwelling older people.
  Overall, I found this study to be profound as it focuses on the association of frailty and disability on dwelling older people as mentioned. It provides information that is useful pertaining to age related changes and those factors that are associated with it. Also noting, that older adults either experience both frailty and disability or one or the other. Since older adults are of a vulnerable group, effective measures should be in place to protect the physical and mental health of older adults. Thus allowing for future prevention and intervention as it relates to frailty and disability. In addition, efficient and effective interventions can delay frailty among older people that can reduce the mortality and morbidity rate.

  References
  Kendhapedi KK & Devasenapathy N. (2019). Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study. British Medical Journal, 9 (10), 1-9.
  https://bmjopen.bmj.com/content/9/10/e032904

  Siriwardhana DD, Hardoon S, Rait G, et al. (2018). Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. British Medical Journal, 8(3), 1-17.
  https://bmjopen.bmj.com/content/8/3/e018195

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  Conflict of Interest:
  None declared.

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• Published on: 16 November 2020

  Association between frailty and disability in rural community-dwelling older adults

  • Tomoyuki Kawada, Professor Nippon Medical School

  Siriwardhana et al. examined the association between frailty and disability in rural community-dwelling older adults, aged ≥ 60 years, in Sri Lanka (1). About 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 instrumental activities of daily living (IADL) limitations was 84.4% among frail adults. 38.7% of frail adults reported ≥1 basic activities of daily living (BADL) limitations. In addition, 58.3% reported both ≥1 physical and cognitive IADL limitations. Furthermore, the odds of being frail for having no IADL limitations significantly decreased. I have some concerns about their study.

  The same authors described the prevalence and associated sociodemographic factors of frailty and pre-frailty (2). They found a strong association of frailty and pre-frailty with aging. In addition, longest-held occupation had a strong association with frailty, and education level was strongly associated with pre-frailty. Furthermore, prevalence of frailty was relatively lower in high-income and upper middle-income countries, compared with prevalence in Sri Lanka. The same authors also evaluated the association of frailty status with overall and domain-specific quality of life (QoL) (3). The estimated reduction in the total quality of life (QoL) score was 7.3% for those frail and 2.1% for those with pre-frail. These reductions could be explained by 'health' and 'independence, control over life and freedom' QoL domains. I suppose that aging, ethnicit...

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  Siriwardhana et al. examined the association between frailty and disability in rural community-dwelling older adults, aged ≥ 60 years, in Sri Lanka (1). About 15.2% were frail and 48.5% were prefrail. The prevalence of ≥1 instrumental activities of daily living (IADL) limitations was 84.4% among frail adults. 38.7% of frail adults reported ≥1 basic activities of daily living (BADL) limitations. In addition, 58.3% reported both ≥1 physical and cognitive IADL limitations. Furthermore, the odds of being frail for having no IADL limitations significantly decreased. I have some concerns about their study.

  The same authors described the prevalence and associated sociodemographic factors of frailty and pre-frailty (2). They found a strong association of frailty and pre-frailty with aging. In addition, longest-held occupation had a strong association with frailty, and education level was strongly associated with pre-frailty. Furthermore, prevalence of frailty was relatively lower in high-income and upper middle-income countries, compared with prevalence in Sri Lanka. The same authors also evaluated the association of frailty status with overall and domain-specific quality of life (QoL) (3). The estimated reduction in the total quality of life (QoL) score was 7.3% for those frail and 2.1% for those with pre-frail. These reductions could be explained by 'health' and 'independence, control over life and freedom' QoL domains. I suppose that aging, ethnicity and socioeconomic status should be considered for evaluating the relationship between frailty, disability and QoL.

  Kojima conducted a meta-analysis to examine the association between baseline frailty status and subsequent risk of developing or worsening ADL and IADL disabilities among community-dwelling older people (4). Overall, frail/prefrail older people were more likely to develop or worsen disabilities, presenting increased pooled odds ratios for ADL and IADL, although there existed high heterogeneity. By summing-up data of prospective high-quality studies, risk estimation might become more stable.

  References
  1. Siriwardhana DD, Weerasinghe MC, Rait G, Scholes S, Walters KR. Association between frailty and disability among rural community-dwelling older adults in Sri Lanka: a cross-sectional study. BMJ Open. 2020 Mar 29;10(3):e034189.
  2. Siriwardhana DD, Weerasinghe MC, Rait G, Falcaro M, Scholes S, Walters KR. Prevalence of frailty in rural community-dwelling older adults in Kegalle district of Sri Lanka: a population-based cross-sectional study. BMJ Open. 2019 Jan 25;9(1):e026314.
  3. Siriwardhana DD, Weerasinghe MC, Rait G, Scholes S, Walters KR. The association between frailty and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka: a cross-sectional study. Qual Life Res. 2019 Aug;28(8):2057-2068.
  4. Kojima G. Frailty as a predictor of disabilities among community-dwelling older people: a systematic review and meta-analysis. Disabil Rehabil. 2017 Sep;39(19):1897-1908.

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  Conflict of Interest:
  None declared.

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