Frailty Phenotype: Evidence of Both Physical and Mental Health Components in Community-Dwelling Early-Old Adults

Background: Demographic aging results in increased incidence of old-age disability. Frailty is a major factor contributing to old-age disability. The aim of this study was to investigate the prevalence of the frailty phenotype as defined by Fried et al and to estimate the need for associated preventative interventions in early-old community-dwelling inhabitants of the southern industrial region of Poland, as well as to investigate the defining components of the frailty phenotype.

Methods: The study group consisted of 160 individuals with an average age of 66.8 ± 4.2 years ( ± SD), 71 (44.4%) of study participants were women. The cohort was randomized out of over 843 thousand community-dwelling Upper Silesian inhabitants aged 60-74 years, who agreed to participate in this project. A comprehensive geriatric assessment (CGA), frailty phenotype test (as described by Fried et al) blood tests and bioimpedance body structure analysis was completed for study participants. Functional assessment included Barthel Index of Activities of Daily Living (Barthel Index), Instrumental Activities of Daily Living Scale (IADL), Mini-Mental State Examination (MMSE), the Timed Up and Go (TUG) test, Tinetti Performance-Oriented Mobility Assessment (POMA), and Geriatric Depression Scale - Short Form (GDS-SF).

Results: Prefrailty was diagnosed in 24.4% of the subjects (95% Confidence Interval (CI) = 17.7-31.0%; 31% in women and 19.1% in men, =0.082) and frailty in 2.5% subjects (95% CI 0.1-4.9%; more frequently in women: 4.2% versus 1.1% in men, =0.046). Having one or more positive frailty criteria was positively associated with depression (odds ratio (OR)=2.85, 95% CI=1.08-7.54, =0.035) and negatively associated with MMSE score (OR=0.72, 95% CI=0.56-0.93, =0.012) and fat-free mass (OR=0.96, 95% CI=0.92-0.99, =0.016) in multivariate logistic regression analysis adjusted for age, sex, disease prevalence, number of medications, functional tests (Barthel Index, IADL, MMSE, GDS-SF), BMI, bioimpedance body composition score, and blood tests.

Conclusion: At least 25% of the early-old community-dwelling population would benefit from a frailty prevention program. The frailty phenotype reflects both physical and mental health in this population.