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Frailty and its association with disability and comorbidity in a community-dwelling sample of seniors in Montreal: a cross-sectional study

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Abstract

Background and aims: The term frailty is used to describe older persons at high risk for adverse health outcomes. In 2001, Fried et al. proposed a now widely cited definition which suggests that frailty is a clinical entity related to, but distinct from, ADL disability and comorbidity. Frailty status was assessed based on the presence of any three of the following five characteristics: shrinking, weakness, poor endurance, slowness, and low activity. The objectives of the current study are to estimate the prevalence of frailty in a sample of community-dwelling older persons, to identify sociodemographic and health variables associated with frailty, and to examine the complex relationships between frailty and comorbidity, ADL disability and IADL disability. Methods: This study is based on cross-sectional analysis of 740 community-dwelling seniors from the Montreal Unmet Needs Study (MUNS). The five characteristics of frailty were operationalised using measures available in MUNS. The Cochran-Mantel-Haenszel test was used to identify variables associated with frailty. Overlaps between frailty, comorbidity and disability were assessed using proportions. Results: Overall, 7.4% were classified as frail, 49.7% prefrail and 42.8% non-frail. Frailty was associated with age, sex, income, education, number of chronic diseases, ADL disability, and IADL disability. Among those classified as frail, 29.1 % had disabilities in ADLs, 92.7% in IADLs and 81.8% had comorbidity. Conclusion: Findings on the relationship between frailty and sociodemographic variables, morbidity and disability, support previous studies, providing further evidence that although frailty seems to be a distinct geriatric concept, it also overlaps with other concepts.

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References

  1. Bergman H. The Canadian Initiative on Frailty and Aging. Aging Clin Exp Res 2003; 15: 1–2.

    Article  PubMed  Google Scholar 

  2. Hogan DB, MacKnight C, Bergman H. Models, definitions, and criteria of frailty. Aging Clin Exp Res 2003; 15: 1–29.

    Article  PubMed  Google Scholar 

  3. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56: M146–56.

    Article  CAS  PubMed  Google Scholar 

  4. Puts MT, Lips P, Deeg DJ. Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc 2005; 53: 40–7.

    Article  PubMed  Google Scholar 

  5. Woods NF, LaCroix AZ, Gray SL et al. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2005; 53: 1321–30.

    Article  PubMed  Google Scholar 

  6. Chin APM, Dekker JM, Feskens EJ, Schouten EG, Kromhout D. How to select a frail elderly population? A comparison of three working definitions. J Clin Epidemiol 1999; 52: 1015–21.

    Article  Google Scholar 

  7. Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173: 489–95.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Ferrucci L, Cavazzini C, Corsi A et al. Biomarkers of frailty in older persons. J Endocrinol Invest 2002; 25: 10–5.

    CAS  PubMed  Google Scholar 

  9. Ottenbacher KJ, Ostir GV, Peek MK, Snih SA, Raji MA, Markides KS. Frailty in older Mexican Americans. J Am Geriatr Soc 2005; 53: 1524–31.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Quail JM, Addona V, Wolfson C, Podoba JE, Levesque LY, Dupuis J. Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over. Eur J Ageing 2007; 4: 45–55.

    Article  Google Scholar 

  11. Podoba JE. Unmet needs for community services among the elderly: impact on health services utilization [PhD Thesis]. Montreal, Canada: McGill University; 2004.

    Google Scholar 

  12. Roccaforte W, Burke WJ, Bayer BL, Wenger SP. Validation of a telephone version of the mini-mental state examination. J Am Geriatr Soc 1992; 40: 697–702.

    CAS  PubMed  Google Scholar 

  13. Beland F, Bergman H, Lebel P et al. A system of integrated care for older persons with disabilities in Canada: results from a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2006; 61: 367–73.

    Article  PubMed  Google Scholar 

  14. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179–86.

    Article  CAS  PubMed  Google Scholar 

  15. Payette H, Gray-Donald K, Cyr R, Boutier V. Predictors of dietary intake in a functionally dependent elderly population in the community. Am J Public Health 1995; 85: 677–83.

    Article  CAS  PubMed  Google Scholar 

  16. Azegami M, Ohira M, Miyoshi K et al. Effect of single and multi-joint lower extremity muscle strength on the functional capacity and ADL/IADL status in Japanese community-dwelling older adults. Nurs Health Sci 2007; 9: 168–76.

    Article  PubMed  Google Scholar 

  17. Alexander NB, Guire KE, Thelen DG et al. Self-reported walking ability predicts functional mobility performance in frail older adults. J Am Geriatr Soc 2000; 48: 1408–13.

    CAS  PubMed  Google Scholar 

  18. Cochran WG. Some methods for strengthening the common chi-square tests. Biometrics 1954; 10: 417–51.

    Article  Google Scholar 

  19. Bandeen-Roche K, Xue QL, Ferrucci L et al. Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 2006; 61: 262–6.

    Article  PubMed  Google Scholar 

  20. Cesari M, Leeuwenburgh C, Lauretani F et al. Frailty syndrome and skeletal muscle: results from the Invecchiare in Chianti study. Am J Clin Nutr 2006; 83: 1142–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med 2006; 166: 418–23.

    PubMed  Google Scholar 

  22. Purser JL, Kuchibhatla MN, Fillenbaum GG, Harding T, Peterson ED, Alexander KP. Identifying frailty in hospitalized older adults with significant coronary artery disease. J Am Geriatr Soc 2006; 54: 1674–81.

    Article  PubMed  Google Scholar 

  23. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356–9.

    Article  PubMed  Google Scholar 

  24. Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, Walston JD. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc 2004; 52: 625–34.

    Article  PubMed  Google Scholar 

  25. Bergman H, Wolfson C, Sourial N et al. Frailty Data (FrData): Examining Candidate Domains of Frailty in the Elderly. [abstract] Can J Geriatr 2006; 9: 70.

    Google Scholar 

  26. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004; 59: M255–63.

    Article  Google Scholar 

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Authors and Affiliations

  1. McGill/University of Montreal Solidage Research Group, Montreal, Canada

    Chek Hooi Wong, Nadia Sourial, Sathya Karunananthan &  Howard Bergman

  2. Geriatric Unit, Division of Medicine, Singapore General Hospital, Singapore

    Chek Hooi Wong

  3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada

    Deborah Weiss, Jacqueline M. Quail & Christina Wolfson

  4. Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Canada

    Deborah Weiss & Christina Wolfson

  5. Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Canada

    Christina Wolfson &  Howard Bergman

  6. Division of Geriatric Medicine, Jewish General Hospital/McGill University, Montreal, Canada

    Howard Bergman

Authors
  1. Chek Hooi Wong
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  2. Deborah Weiss
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  3. Nadia Sourial
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  4. Sathya Karunananthan
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  5. Jacqueline M. Quail
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  6. Christina Wolfson
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  7. Howard Bergman
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Correspondence to Howard Bergman.

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Wong, C.H., Weiss, D., Sourial, N. et al. Frailty and its association with disability and comorbidity in a community-dwelling sample of seniors in Montreal: a cross-sectional study. Aging Clin Exp Res 22, 54–62 (2010). https://doi.org/10.1007/BF03324816

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  • DOI: https://doi.org/10.1007/BF03324816

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