FRAILTY IS A GERIATRIC SYNDROME CHARACTERIZED BY MULTIPLE IMPAIRMENTS: A COMPREHENSIVE APPROACH IS NEEDED

Abstract

Objective: To evaluate the prevalence of frailty and the associated multimorbidity and functional impairments among community-dwelling middle-aged and elderly people in Taiwan. Design: a cross-sectional study. Setting: communities in I-Lan County of Taiwan. Participants: 1839 community-dwelling people aged 50 years and older. Intervention: None. Measurements: Frailty defined by Fried’s criteria, Charlson’s comorbidity index (CCI), Functional Autonomy Measurement System (SMAF), Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Nutrition Assessment (MNA), Mini–Mental State Examination (MMSE), and Short Form-12 quality of life questionnaire. Results: Overall, 1839 subjects (mean age: 63.9±9.3 years, 47.5% males) participated in this study and men were more likely to have higher educational level, more smoking and alcohol drinking habit. The prevalence of frailty was 6.8% in this study, while pre-frailty was 40.5% and 53.7% of all participants were robust. Compared to subjects with different frailty status, age, education year, alcohol drinking, hypertension, diabetes mellitus, hyperlipidemia, CCI, walking speed, handgrip strength, score of SMAF, CES-D, MNA, MMSE, quality of life were significantly different between groups (P all< 0.05). Older age, poorer physical function, poorer cognitive function, poorer nutritional status, more depressive symptoms, higher CCI and poorer quality of life were all independently associated with frailty. Conclusions: Frailty was not simply a geriatric syndrome, but the combination of multiple geriatric syndromes. Further study is needed to evaluate the clinical benefits of intervention programs for community-dwelling middle-aged and older people to reverse frailty and its associated functional impairments.