Frailty – prevalence of acutely hospitalized seniors from 1995 to 2022

Česká verzia

Authors: Weber Pavel; Weberová Dana; Polcarová Vlasta; Bielaková Katarína
Authors place of work: Klinika interní, geriatrie a praktického lékařství Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice, Brno
Published in the journal: Geriatrie a Gerontologie 2023, 12, č. 2: 65-71
Category: Original Article

Summary

Objective: Frailty (F) is a medical syndrome associated with the rise of sarcopenia with an impact on quality of life, health care, and health care as a whole.

Methodology: We present a retrospective cohort study of patients from 1995 to 2022 who were acutely admitted to our clinic. There were a total of 29,646 people aged 65 to 105. Of this number, there were 18,867 women with an average age of 81.7 ± 7.7 years, while there were only 10,787 men with an average age of 79.0 ± 7.6 years. Women were almost 3 years older than men (p < 0, 01).

Results: In the subset of younger seniors (65– 74 years), the occurrence of F in men ranged between 12 and 20 % and in women between 13 and 19 %. With increasing age, there is an obvious increase in the occurrence of F – in the subset aged 75–84 years in men to 16–33 % and in women to 18–24 %. In the oldest age subgroup ≥ 85 years, there is a significant rise in F – to 25–40 % in men and 26–38 % in women. Pre-frailty in men varied between 36–50 % and in women between 27–55 %. Mortality was significantly higher in individuals acutely hospitalized with F in men in all age groups 31–32 % and in women 22–26 %; while in the group of acutely admitted patients without F, it increased in men with age from 3.0 to 6 % and in women from 2.1 to 4 %.

Conclusion: Our data point to the importance of monitoring frailty and the risk of increased mortality associated with it in acutely hospitalized seniors and underline prevention and treatment options.

Keywords:

mortality – frailty syndrome – geriatricization of medicine – acute hospitalization of the elderly – aging of the population

Zdroje

1. Fillit HM, Rockwood K, Young JB. Brocklehurst’s textbook of geriatric medicine and gerontology. Philadelphia: Elsevier Health Sciences, 2016.

2. Kastner M, Cardoso R, Lai Y, et al. Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta- -analysis. CMAJ 2018; 190(34): E1004–E1012.

3. Pathy MS John, Finucane P (eds.). Geriatric medicine: problems and practice paperback. New York: Springer, 2014.

4. Fried LP, Ferrucci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004; 59(3): 255–263.

5. Comer A, Fettig L, Torke AM. Identifying goals of care. Med Clin North Am 2020; 104(5): 767–775.

6. Fried LP, Tangen CM, Walston J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146– 56.

7. Smailhodzic E, Hooijsma W, Boonstra A, et al. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Services Research 2016; 16: 442.

8. Krajčík Š, a kol. Geriatria. Bratislava: Herba, 2022.

9. Balsa A, Diáz C. Social interactions in health behaviors and conditions. https: //doi.org/10.1093/ acrefore/9780190625979.013.17 Published online: 26 March 2019.

10. Hazzard WR. Scientific progress in geriatric syndromes: Earning an «A» on the 2007 Report Card on Academic Geriatrics. J Amer Geriat Soc 2007; 55(5): 794–796.

11. Topinková E, Berková M, Mádlová P, et al. Krátká baterie pro testování fyzické zdatnosti seniorů a její využití pro diagnózu geriatrické křehkosti v klinické praxi. Geri a Gero 2013; 2(1): 43–49.

12. Ghachem A, Fried LP, Legault V, et al. Evidence from two cohorts for the frailty syndrome as an emergent state of parallel dysregulation in multiple physiological systems. Biogerontology 2021; 22(1): 63–79.

13. Fried LP, Cohen AA, Xue QL, al. The physical frailty syndrome as a transition from homeostatic symphony to cacophony. Nat Aging 2021; 1(1): 36–46.

14. Morley JE, Vellas B, van Kan GA, et al. Frailty consensus: a call to action. J Am Med Dir Assoc 2013; 14(6): 392–397.

15. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 5(173): 489– 495.

16. Nakazato Y, Sugiyama T, Ohno R, et al. Estimation of homeostatic dysregulation and frailty using biomarker variability: a principal component analysis of hemodialysis patients. Sci Rep 2020; 10(1): 10314.

17. Dansereau G, Wey TW, Legault V, et al. Conservation of physiological dysregulation signatures of aging across primates. Aging Cell 2019; 18(2): e12925.

18. Fried LP, Tangen CM, Walston J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146– 156.

19. Walston J, Hadley EC, Ferrucci L, et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Amer Geriat Soc 2006; 54(6): 991–1001.

20. Rodríguez-Romero R, Herranz- -Rodríguez C, Kostov B, et al. Intervention to reduce perceived loneliness in community-dwelling older people. Scand J Caring Sci 2021; 35(2): 366–374.

21. Laurindo LF, Barbalho SM, Guiguer EL, et al. GLP-1a: Going beyond traditional use. Int J Mol Sci 2022; 23(2): 739.

22. Inouye SK. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Amer Geriat Soc 2007; 55(5): 780–791.

23. Hoogendijk EO, Afilalo J, Ensrud KE, et al. Frailty: implications for clinical practice and public health. Lancet 2019; 394(10206): 1365–1375.

24. Nascimento CM, Ingles M, Salvador- Pascual A, et al. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med 2019; 132: 42–49.

25. Ni Lochlainn M, Cox NJ, Wilson T. Nutrition and frailty: opportunities for prevention and treatment. Nutrients 2021; 13(7): 2349.

26. Cederholm T, Morley JE. Sarcopenia: the new definitions. Curr Opin Clin Nutr Metab Care 2015; 18(1): 1–4.

27. Pritchard JM, Kennedy CC, Karampatos S, et al. Measuring frailty in clinical practice: a comparison of physical frailty assessment methods in a geriatric out-patient clinic. BMC Geriatr 2017; 17(1): 264.

28. Collard RM, Boter H, Schoevers RA, et al. Prevalence of frailty in community-dwelling older persons: A systematic review. J Am Geriatr Soc 2012; 60: 1487– 1492.

29. Ritt M, Ritt JI, Sieber CCh, et al. Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards. Clin Interv Aging 2017; 12: 293–304.

30. Belga S, Majumdar SR, Kahlon S, et al. Comparing three different measures of frailty in medical inpatients: Multicenter prospective cohort study examining 30-day risk of readmission or death. J Hosp Med 2016; 11(8): 556– 562.

31. Pilotto A, Rengo F, Marchionni N, et al. Comparing the prognostic accuracy for all-cause mortality of frailty instruments: a multicentre 1-year follow-up in hospitalized older patients. PLoS One 011; 7(1): e29090.

32. Qian-Li Xue, Bandeen-Roche K, Jing Tian, et al. Progression of physical frailty and the risk of all- -cause mortality: Is there a point of no return? J Am Geriatr Soc 2021; 69(4): 908–915.

33. Romero-Ortuno R, Wallis SJ, Biram RW, et al. Clinical frailty adds to acute illness severity in predicting mortality in hospitalized older adults: an observational study. Eur J Intern Med 2016; 35: 24–34.

34. Weber P, Ambrošová P, Weberová D, et al. Geriatrické syndromy a syndrom frailty – zlatý grál geriatrické medicíny. Vnitř Lék 2011; 57(6): E2010–18.

35. Hudáková A, Majerníková L, Obročníková A, et al. Evaluácia syndromu frailty v rámci fyzickej schopnosti u seniorov. Rehabil Fyz Lék 2020; 27(3): 156–163.

36. Vaňková H, Topinková E, Hrnčiariková D, et al. Vyhodnocení syndromu křehkosti (frailty) u geriatrického pacienta. Geri a Gero 2023; 12(1): 5–8.

37. Nooijen CFJ, Blom V, Ekblom O, al. The effectiveness of multi-component interventions targeting physical activity or sedentary behaviour amongst office workers: a three-arm cluster randomised controlled trial. BMC Public Health 2020; 20(1): 1329.

38. Rodríguez-Mañas L, Féart C, Mann G, et al.; on behalf of the FOD-CC group. Searching for an operational definition of frailty: A Delphi method-based consensus statement. The Frailty Operative Definition–Consensus Conference Project. J Gerontol A Biol Sci Med Sci 2013; 68: 62–67.