Frailty – relationship to selected comorbidities in hospitalized seniors over 28 years
Authors:
Weber Pavel 1,2; Weberová Dana 3; Meluzínová Hana 2; Polcarová Vlasta 1; Bielaková Katarína 1
Authors place of work:
Všeobecná interní klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
1; DIASTOP, diabetologická a interní ambulance, U Pošty 14, Brno
2; Interní gastroenterologická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno
3
Published in the journal:
Geriatrie a Gerontologie 2024, 13, č. 2: 70-76
Category:
Original Article
Summary
Objective: In the foreground of frailty (F) syndrome, the dysregulation of physiological systems in a broad sense during aging is still reported without identification of the immediate specific cause. With this work, we want to point out some aspects and relationships of F to selected comorbidities typical of older age over the past 28 years.
Methodology: This is a retrospective cohort study of patients from 1995–2022 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: Ischemic heart disease and hypertension occurred in the years 1995-2022 in both sexes, regardless of F, in approximately ²⁄³ of acutely hospitalized patients. Similarly, atrial fibrillation oscillates permanently in around ¹⁄ of patients. Obesity with a BMI over 30 fluctuates between ¼ and ¹⁄³ without difference on F for both sexes. Malnutrition with a BMI below 19 is two- to three-fold present at all times in both sexes with F and pre-F. Diabetes affects around a third of hospitalized patients; chronic renal insufficiency occurred in 15 to 27 %, and malignancy was present in one-fifth to one-tenths of admissions without any apparent predominant preference. Mortality was tenfold higher in individuals acutely hospitalized with F and pre-F in both sexes. It ranged between 23–27.6 % for men and 16.5–18.8 % for women; while in the group of acutely admitted patients without F, it was from 2.0 to 4.1 % in men and 1.3-3.2 % in women. The mortality trajectory of individuals with F and pre-F over 28 years in acutely hospitalized patients remains unchanged.
Conclusion: The presence of syndrome F as an unfavorable prognostic factor should fundamentally modify the strategy of current diagnosis and further treatment (including prevention). Effective management of F is based on correct prediction, prevention and rapid therapy of possible complications both during acute and elective procedures.
Keywords:
geriatrization of medicine, population aging, acute hospitalization of the elderly, frailty syn-drome, comorbidities, mortality
Zdroje
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