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Frailty in Community-Dwelling Older People
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Frailty in Community-Dwelling Older People

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Community Care".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 31100

Special Issue Editor

Prof. Dr. Robbert Gobbens

E-Mail Website1 Website2
Guest Editor
Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
Interests: nursing; quality of life; gerontology; patient education; geriatric; nursing instrument development; geriatric assessment; geriatric psychiatry; medication adherence; aging research; elderly; questionnaire design
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With a growing geriatric population worldwide, frailty is becoming an increasingly important topic, because frailty is often closely related to aging. To deal with the challenges resulting from the aging population, services and policies are increasingly focused on independently living in the community rather than relying on institutions, e.g., nursing homes. This fits the wishes of many older people, who prefer to stay in their own homes for as long as possible.

However, frail older people living independently in the community have a high risk for adverse outcomes such as lower quality of life, disability, an increase in healthcare utilization (e.g., hospitalization and institutionalization), and mortality. Therefore, it is important to identify frail community-dwelling older people as early as possible and to implement interventions that can prevent or delay poor outcomes. Therefore, it is important that we gain more knowledge about the assessment of frailty, determinants of frailty, the associations between frailty and adverse outcomes, perspectives of healthcare professionals on frailty (e.g., general practitioners and nurses, ), and most importantly, how to prevent frailty or poor outcomes. For example, we still lack knowledge on which interventions can prevent physical, psychological, and social frailty.

This Special Issue of Healthcare seeks commentaries, original research, short reports, and reviews on frailty in community-dwelling older people. Both contributions based on quantitative and qualitative research can be submitted.

Prof. Dr. Robbert Gobbens
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • frailty
  • community-dwelling older people
  • primary care
  • prevention
  • disability
  • quality of life
  • healthcare utilization
  • mortality
  • measurement
  • determinants

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Published Papers (15 papers)

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Editorial

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3 pages, 199 KiB  
Editorial
Frailty in Community-Dwelling Older People
by Robbert J. Gobbens
Healthcare 2023, 11(16), 2298; https://doi.org/10.3390/healthcare11162298 - 15 Aug 2023
Viewed by 732
Abstract
With a growing aging population around the world [...] Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)

Research

Jump to: Editorial, Other

14 pages, 603 KiB  
Article
Evaluation of Psychophysical Fitness in Drivers over 65 Years of Age
by Enrique Mirabet, Macarena Tortosa-Perez, Francisco Tortosa and Francisco González-Sala
Healthcare 2023, 11(13), 1927; https://doi.org/10.3390/healthcare11131927 - 3 Jul 2023
Cited by 2 | Viewed by 916
Abstract
Background: The deterioration of cognitive and psychophysical ability associated with aging has an effect on road safety, especially in the driving of vehicles. The current study’s main objective is to evaluate the psychophysical aptitudes in drivers over 65 years of age in a [...] Read more.
Background: The deterioration of cognitive and psychophysical ability associated with aging has an effect on road safety, especially in the driving of vehicles. The current study’s main objective is to evaluate the psychophysical aptitudes in drivers over 65 years of age in a sample of drivers in Spain. Methods: The sample was formed of a total of 1663 drivers who attended a Driver Recognition Center. The evaluation of their psychophysical aptitudes was carried out following the Medical-Psychological Exploration Protocol for Driver Recognition Centers, edited by the Ministry of Health and the General Directorate of Traffic. Results: The results show increased restrictions in the evaluation of driving ability with age, which are especially significant after 75 years of age. Regarding sex, 70.1% of women have an approved evaluation, compared to men aged between 65–69, although from 69 onwards, the percentage of approved women decreases significantly. The loss of visual capabilities and poor performance in psycho-technical tests are the main causes associated with an evaluation with restrictions, with the number of restrictive conditions increasing with age. Conclusions: There is an increase in the number of cases with age-related restrictions, especially in the case of women and ophthalmologic-related problems, although the majority of drivers over 65 years old continue driving, thus continuing with a practice that has been related to the well-being and quality of life of older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
21 pages, 1525 KiB  
Article
Predicting Disability Using a Nomogram of the Tilburg Frailty Indicator (TFI)
by Robbert J. Gobbens, Livia M. Santiago, Izabella Uchmanowicz and Tjeerd van der Ploeg
Healthcare 2023, 11(8), 1150; https://doi.org/10.3390/healthcare11081150 - 17 Apr 2023
Cited by 3 | Viewed by 1060
Abstract
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop [...] Read more.
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop nomograms with items of the Tilburg Frailty Indicator (TFI) as predictors by using cross-sectional and longitudinal data (follow-up of five and nine years), focusing on the prediction of total disability, disability in activities of daily living (ADL), and disability in instrumental activities of daily living (IADL). At baseline, 479 Dutch community-dwelling people aged ≥75 years participated. They completed a questionnaire that included the TFI and the Groningen Activity Restriction Scale to assess the three disability variables. We showed that the TFI items scored different points, especially over time. Therefore, not every item was equally important in predicting disability. ‘Difficulty in walking’ and ‘unexplained weight loss’ appeared to be important predictors of disability. Healthcare professionals need to focus on these two items to prevent disability. We also conclude that the points given to frailty items differed between total, ADL, and IADL disability and also differed regarding years of follow-up. Creating one monogram that does justice to this seems impossible. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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16 pages, 656 KiB  
Article
Effect of the Active Aging-in-Place–Rehabilitation Nursing Program: A Randomized Controlled Trial
by Ana da Conceição Alves Faria, Maria Manuela F. P. S. Martins, Olga Maria Pimenta Lopes Ribeiro, João Miguel Almeida Ventura-Silva, Esmeralda Faria Fonseca, Luciano José Moreira Ferreira and José Alberto Laredo-Aguilera
Healthcare 2023, 11(2), 276; https://doi.org/10.3390/healthcare11020276 - 16 Jan 2023
Cited by 4 | Viewed by 2501
Abstract
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) [...] Read more.
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants’ homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg’s perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the older adults’ lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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13 pages, 287 KiB  
Article
The Impact of Frailty and Geriatric Syndromes on the Quality of Life of Older Adults Receiving Home-Based Healthcare: A Cross-Sectional Survey
by Lamprini Tasioudi, Antonia Aravantinou-Karlatou, Savvato Karavasileiadou, Wafa Hamad Almegewly, Emmanouil Androulakis and Christos Kleisiaris
Healthcare 2023, 11(1), 82; https://doi.org/10.3390/healthcare11010082 - 27 Dec 2022
Cited by 3 | Viewed by 2448
Abstract
Purpose: To identify the effect of frailty and geriatric syndromes on the quality of life (QoL), of older adults receiving home care, taking into consideration their socioeconomic and homebound status, including multi-comorbidities. Patients and Methods: This cross-sectional study enrolled elders aged (≥65) years [...] Read more.
Purpose: To identify the effect of frailty and geriatric syndromes on the quality of life (QoL), of older adults receiving home care, taking into consideration their socioeconomic and homebound status, including multi-comorbidities. Patients and Methods: This cross-sectional study enrolled elders aged (≥65) years old, registered members of “Help at Home” programs in the Reference Region of Crete, from March to May 2019. Participants were screened using the WHOQOL-BREF for Quality of Life, geriatric syndromes such as frailty using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), for cognitive function and the Geriatric Depression Scale (GDS), for the assessment of depression. Results: The mean age of the 301 participants was 78.45 (±7.87) years old. The prevalence of frailty was 38.5%, severe depression 13.6%, cognitive dysfunction 87.8% and severe comorbidity 70.6%. Intriguingly, none of the participants (0%) was identified as free of comorbidity (CCI = 0–1). The overall QoL (ranging from 4–20) of the study participants was 13.24 (±4.09). The bivariate analysis showed that overall QoL significantly differed among older adults with frailty (15.91 vs. 11.56, p < 0.001), cognitive dysfunction (15.42 vs. 12.90, p < 0.001), depression (14.90 vs. 9.31, p < 0.001), and disability in Activities of Daily Living (13.67 vs. 10.67, p = 0.002), compared to non-frail, normal cognition and depression, and independent elders, respectively. Multiple linear regression models revealed that frail and depressive elders reported significantly lower QoL (β = −2.65, p < 0.001 and (β = −5.71, p < 0.001), compared to non-frail and older adults with no depressive symptoms, respectively, despite the fact that this association was not significant for older adults with dementia (β = −2.25, p = 0.159), even after adjusting for potential confounding effects (age, gender, comorbidity, homebound status, etc.). Conclusion: frailty and geriatric syndromes including comorbidities are important risk factors for “poor” QoL among older adults receiving home-based healthcare. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
11 pages, 579 KiB  
Article
Overlap of Physical, Cognitive, and Social Frailty Affects Ikigai in Community-Dwelling Japanese Older Adults
by Soma Tsujishita, Masaki Nagamatsu and Kiyoshi Sanada
Healthcare 2022, 10(11), 2216; https://doi.org/10.3390/healthcare10112216 - 4 Nov 2022
Cited by 9 | Viewed by 4543
Abstract
This study aimed to investigate whether the overlap of physical, cognitive, and social frailty affects Ikigai in community-dwelling Japanese older adults. Participants were 116 community-dwelling older adult Japanese men and women. Associations of physical, cognitive, and social frailty with falls, daily living assessment, [...] Read more.
This study aimed to investigate whether the overlap of physical, cognitive, and social frailty affects Ikigai in community-dwelling Japanese older adults. Participants were 116 community-dwelling older adult Japanese men and women. Associations of physical, cognitive, and social frailty with falls, daily living assessment, and Ikigai were analyzed by group comparisons and multivariate analyses. Physical, cognitive, and social frailty were associated with the risk of falls and Ikigai. An increase in the number of frailty category overlaps was associated with an increased risk of falls and decrease in Ikigai. Multivariate analyses adjusted for confounding factors showed that physical and cognitive frailty were related to Ikigai. In conclusion Two or more overlapping numbers of physical, cognitive, and social frailty had adverse effects on Ikigai in community-dwelling Japanese older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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12 pages, 1164 KiB  
Article
The Impact of Socioeconomic Factors and Geriatric Syndromes on Frailty among Elderly People Receiving Home-Based Healthcare: A Cross-Sectional Study
by Antonia Aravantinou-Karlatou, Savvato Kavasileiadou, Simeon Panagiotakis, Chariklia Tziraki, Wafa Almegewly, Emmanouil Androulakis and Christos Kleisiaris
Healthcare 2022, 10(10), 2079; https://doi.org/10.3390/healthcare10102079 - 19 Oct 2022
Cited by 2 | Viewed by 2734
Abstract
Purpose: To evaluate frailty and its relationship with geriatric syndromes in the context of socioeconomic variables. Patients and Methods: In this cross-sectional study, elderly people aged 65 years old and over who received homecare in the reference region of Crete, Greece, were enrolled. [...] Read more.
Purpose: To evaluate frailty and its relationship with geriatric syndromes in the context of socioeconomic variables. Patients and Methods: In this cross-sectional study, elderly people aged 65 years old and over who received homecare in the reference region of Crete, Greece, were enrolled. Geriatric syndromes such as frailty, dementia, and depression were evaluated using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), and the Geriatric Depression Scale (GDS), respectively. Level of education, annual individual income, disability in Activities of Daily Living (ADL) and homebound status were also assessed as ‘socioeconomic factors.’ Results: The mean age of 301 participants was 78.45 (±7.87) years old. A proportion of 38.5% was identified as frail. A multiple logistic regression model revealed that elderly people with cognitive dysfunction were more likely to be frail (OR = 1.65; 95% CI: 0.55–4.98, p = 0.469) compared to those with normal cognition, but this association was not significant. Although elderly people with mild depression were significantly more likely to be frail (OR = 2.62; CI: 1.33–5.17, p = 0.005) compared to those with normal depression, the association for elderly people with severe depression (OR = 2.05, CI: 0.80–5.24, p = 0.134) was not significant. Additionally, comorbidity (OR = 1.06, CI: 0.49–2.27, p = 0.876) was not associated with frailty, suggesting that comorbidity is not a risk factor for frailty. In addition, patients with mild depression were significantly more likely to report frailty (OR = 2.62, CI:1.33–5.17, p = 0.005) compared to those with normal depression, whereas elders with an annual individual income (>EUR 4500) were less likely to be frail (OR = 0.45, CI: 0.25–0.83, p = 0.011) compared to those with <EUR 4500 per year. Conclusions: Our data analysis shows that higher annual individual income and mild depression were independently associated with frailty, suggesting that a lower poverty threshold and mild depression are risk factors for frailty. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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8 pages, 791 KiB  
Article
Frail Older Adults without Occupational Dysfunction Maintain Good Subjective Well-Being: A Cross-Sectional Study
by Keisuke Fujii, Yuya Fujii, Yuta Kubo, Korin Tateoka, Jue Liu, Koki Nagata, Daiki Nakashima and Tomohiro Okura
Healthcare 2022, 10(10), 1922; https://doi.org/10.3390/healthcare10101922 - 30 Sep 2022
Cited by 3 | Viewed by 1349
Abstract
The purpose of this cross-sectional study was to clarify the relationship between frailty/occupational dysfunction (OD), both with and without, and subjective well-being among community-dwelling older adults. A total of 2308 (average age: 72.2 ± 5.1, female: 47.0%) independently living older adults in Kasama [...] Read more.
The purpose of this cross-sectional study was to clarify the relationship between frailty/occupational dysfunction (OD), both with and without, and subjective well-being among community-dwelling older adults. A total of 2308 (average age: 72.2 ± 5.1, female: 47.0%) independently living older adults in Kasama City, Japan, completed a self-administered questionnaire in November 2019. OD, frailty, and subjective well-being were assessed. Participants were classified into six groups: robust and healthy occupational function (HOF), robust and OD, pre-frail and HOF, pre-frail and OD, frail and HOF, and frail and OD. To examine the relationship between frailty/OD and subjective well-being, we performed an analysis of variance with subjective well-being as the dependent variable and with and without frailty/OD (six groups) as the independent variables. The results showed a significant association between with and without frailty/OD and subjective well-being in community-dwelling older adults. The subjective well-being of the pre-frail and HOF group was significantly better than that of the robust and OD group. Furthermore, the subjective well-being of the frail and HOF group was significantly better than that of the pre-frail and OD group. These results can be used to develop a new support method for frailty. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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11 pages, 956 KiB  
Article
How to Make Primary Healthcare More Popular: Evidence from the Middle-Aged and Elderly in China
by Liping Fu, Ya’nan Fang, Shu Yang and Yanqing Xu
Healthcare 2022, 10(9), 1783; https://doi.org/10.3390/healthcare10091783 - 16 Sep 2022
Cited by 3 | Viewed by 2155
Abstract
Since 2001, China has been an aging society; it is expected to become superaged by 2033. This rapid aging trend poses a challenge to the elderly regarding their pension services and healthcare. Primary healthcare has great potential for serving older adults in the [...] Read more.
Since 2001, China has been an aging society; it is expected to become superaged by 2033. This rapid aging trend poses a challenge to the elderly regarding their pension services and healthcare. Primary healthcare has great potential for serving older adults in the community, yet it is not popular. This study used 1977 samples from the 2018 China Health and Retirement Longitudinal Study database to explore the use of outpatient services in primary care institutions among the middle-aged and elderly. Using a structural equations model, we constructed a framework to explore pathways leading to primary outpatient use. We discovered that the supply of primary health services had a significant direct and mediating effect on the utilization of primary outpatient services, and that community pension services may indirectly discourage it. In addition, the supply of primary health services has a suppressor effect between medical insurance and primary outpatient utilization. Health insurance directly promotes primary outpatient utilization, while the supply of primary care institutions suppresses the positive influence of medical insurance on the utilization of primary outpatient services. Therefore, community pension services should pay attention to differentiated services. Moreover, adjusting the coordinated development of medical insurance and the supply of primary healthcare could enhance the positive effects of medical insurance for outpatients. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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14 pages, 1685 KiB  
Article
Nurses’ Opinions on Frailty
by Robbert J. Gobbens, Sofie Vermeiren, An Van Hoof and Tjeerd van der Ploeg
Healthcare 2022, 10(9), 1632; https://doi.org/10.3390/healthcare10091632 - 26 Aug 2022
Cited by 5 | Viewed by 1828
Abstract
Nurses come into frequent contact with frail older people in all healthcare settings. However, few studies have specifically asked nurses about their views on frailty. The main aim of this study was to explore the opinions of nurses working with older people on [...] Read more.
Nurses come into frequent contact with frail older people in all healthcare settings. However, few studies have specifically asked nurses about their views on frailty. The main aim of this study was to explore the opinions of nurses working with older people on the concept of frailty, regardless of the care setting. In addition, the associations between the background characteristics of nurses and their opinions about frailty were examined. In 2021, members of professional association of nurses and nursing assistants in the Netherlands (V&VN) received a digital questionnaire asking their opinions on frailty, and 251 individuals completed the questionnaire (response rate of 32.1%). The questionnaire contained seven topics: keywords of frailty, frailty domains, causes of frailty, consequences of frailty, reversing frailty, the prevention of frailty, and addressing frailty. Regarding frailty, nurses especially thought of physical deterioration and dementia. However, other domains of human functioning, such as the social and psychological domains, were often mentioned, pointing to a holistic approach to frailty. It also appears that nurses can identify many causes and consequences of frailty. They see opportunities to reverse frailty and an important role for themselves in this process. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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10 pages, 557 KiB  
Article
Association between Walking Habit and Physical Frailty among Community-Dwelling Older Adults
by Tsubasa Yokote, Harukaze Yatsugi, Tianshu Chu, Xin Liu and Hiro Kishimoto
Healthcare 2022, 10(8), 1396; https://doi.org/10.3390/healthcare10081396 - 27 Jul 2022
Cited by 3 | Viewed by 1602
Abstract
The aim of this cross-sectional study was to determine whether older adults who practice walking have a lower risk of physical frailty than those who do not. The study subjects were 846 older adults and were not certified as needing support or nursing [...] Read more.
The aim of this cross-sectional study was to determine whether older adults who practice walking have a lower risk of physical frailty than those who do not. The study subjects were 846 older adults and were not certified as needing support or nursing care. The subjects were classified as being physically frail or pre-frail or being robust, according to the revision of the Cardiovascular Health Study criteria. We classified the subjects by questionnaire into a no-exercise group, walking-only group, walking plus other exercise group, and exercise other than walking group. In logistic regression analyses, the odds ratio (OR) and 95% confidence interval (95%CI) were shown. Compared to the no-exercise group, the OR (95%CI) for physical frailty was 0.85 (0.48–1.49) for the walking-only group, 0.54 (0.36–0.83) for the walking plus other exercise group, and 0.67 (0.47–0.97) for the exercise other than walking group. In the components of physical frailty, the walking plus other exercise group and the exercise other than group had significantly lower ORs for exhaustion. Older adults who only practiced walking as an exercise do not have lower risks of physical frailty and pre-frailty. Older adults who combine walking with other exercises or practice non-walking exercises have lower risks of them. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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12 pages, 815 KiB  
Article
Intestinal Permeability Associated with the Loss of Skeletal Muscle Strength in Middle-Aged and Older Adults in Rural Area of Beijing, China
by Cheng Li, Yaru Li, Nan Wang, Zhiwen Ge, Zhengli Shi, Jia Wang, Bingjie Ding, Yanxia Bi, Yuxia Wang and Zhongxin Hong
Healthcare 2022, 10(6), 1100; https://doi.org/10.3390/healthcare10061100 - 13 Jun 2022
Cited by 7 | Viewed by 1669
Abstract
The association between intestinal permeability and sarcopenia remains unclear, and few studies have mentioned the relationship between intestinal permeability and skeletal muscle strength. The present cross-sectional community study was conducted in a rural area of Beijing to explore the association between intestinal permeability [...] Read more.
The association between intestinal permeability and sarcopenia remains unclear, and few studies have mentioned the relationship between intestinal permeability and skeletal muscle strength. The present cross-sectional community study was conducted in a rural area of Beijing to explore the association between intestinal permeability and handgrip strength (HGS) in middle-aged and older adults. Serum lipopolysaccharide (LPS), diamine oxidase (DAO) and D-lactate were detected to evaluate intestinal permeability. Gut microbiota (GM) and its potential interaction were also analyzed in the decision tree model. HGS was negatively correlated with DAO (r = −0.396, p < 0.01) in males. The negative association between HGS and DAO remained significant with the adjustment of covariates (β = −1.401, p < 0.05). Serum DAO and LPS were both negatively associated with HGS in middle-aged and older males, with the significant interactions of GM in the decision tree model, and D-lactate showed a negative association with HGS in females. Therefore, intestinal permeability was associated with the loss of skeletal muscle strength in middle-aged and older adults, and serum DAO may be a novel predictor for the loss of skeletal muscle strength in middle-aged and older males. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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12 pages, 1640 KiB  
Article
Admission to the Long-Term Care Facilities and Institutionalization Rate in Community-Dwelling Frail Adults: An Observational Longitudinal Cohort Study
by Susanna Gentili, Fabio Riccardi, Leonardo Emberti Gialloreti, Paola Scarcella, Alessandro Stievano, Maria Grazia Proietti, Gennaro Rocco and Giuseppe Liotta
Healthcare 2022, 10(2), 317; https://doi.org/10.3390/healthcare10020317 - 7 Feb 2022
Cited by 5 | Viewed by 1749
Abstract
The worldwide aging and the increase of chronic disease impacted the Health System by generating an increased risk of admission to Long-Term Care (LTC) facilities for older adults. The study aimed to evaluate the admission rate to LTC facilities for community-dwelling older adults [...] Read more.
The worldwide aging and the increase of chronic disease impacted the Health System by generating an increased risk of admission to Long-Term Care (LTC) facilities for older adults. The study aimed to evaluate the admission rate to LTC facilities for community-dwelling older adults and investigate factors associated with these admissions. A secondary data analysis stemming from an observational longitudinal cohort study (from 2014 to 2017) was performed. The sample was made up by 1246 older adults (664 females and 582 males, mean age 76.3, SD ± 7.1). The LTC facilities access rate was 12.5 per 1000 observations/ year. Multivariable Linear Regression identified frailty, cardiovascular disease, and incapacity to take medicine and manage money as predictors of the LTC facilities’ access rate. The Multiple Correspondence Analysis identified three clusters: those living at home with comorbidities; those living in LTC facilities who are pre-frail or frail; those very frail but not linked to residential LTC. The results indicate that access to LTC facilities is not determined by severe disability, severe comorbidity, and higher frailty levels. Instead, it is related to moderate disability associated with a lack of social support. Therefore, the care policies need to enhance social interventions to integrate medical, nursing, and rehabilitative care. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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Other

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9 pages, 819 KiB  
Opinion
Frailty in Kingdom of Saudi Arabia—Prevalence and Management, Where Are We?
by Asim Muhammed Alshanberi
Healthcare 2023, 11(12), 1715; https://doi.org/10.3390/healthcare11121715 - 12 Jun 2023
Cited by 3 | Viewed by 1275
Abstract
A recent report from the United Nations state that the percentage of elderly individuals in the Kingdom of Saudi Arabia (KSA) will witness a sharp increase in the next three decades (5.6% in 2017 to 23% by 2050). This situation will lead to [...] Read more.
A recent report from the United Nations state that the percentage of elderly individuals in the Kingdom of Saudi Arabia (KSA) will witness a sharp increase in the next three decades (5.6% in 2017 to 23% by 2050). This situation will lead to an increased prevalence of comorbidities and hence, will require close monitoring and constant care of such individuals who are prone to suffer from complications such as arthritis, cardiovascular disorders, diabetes, neurological disorders, etc. Frailty is one such age-related phenomenon which enhances the risk of falling, functional restrictions and greater vulnerability to adverse consequences, which tend to lead to institutionalization. Such factors highlight the importance of the urgent awareness for circumventing the progression of frailty toward a compromised health status. This concise report is an attempt to sum up the relevant research articles published with regard to frailty and concomitant diseases in the last 5 years. It also sums up the research on frailty in the KSA elderly population, till date. This article reflects the opinions of an author on tackling such issues through a well-directed mechanism involving interdisciplinary transitional care and geriatric co-management. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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14 pages, 535 KiB  
Systematic Review
Prevalence of Frailty among Community-Dwelling Older Adults in Asian Countries: A Systematic Review and Meta-Analysis
by Thi-Lien To, Thanh-Nhan Doan, Wen-Chao Ho and Wen-Chun Liao
Healthcare 2022, 10(5), 895; https://doi.org/10.3390/healthcare10050895 - 12 May 2022
Cited by 20 | Viewed by 2960
Abstract
This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived [...] Read more.
This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived in Asia. Cross-sectional or national longitudinal population-based cohort studies completed with validated instruments were selected. Twenty-one studies with 52,283 participants were included. The pooled prevalence rate of frailty was 20.5% (95% CI = 15.5% to 26.0%). The estimated frailty prevalence was 14.6% (95% CI = 10.9% to 18.8%) while assessed by the Fried frailty phenotype, 28.0% (95% CI = 21.3% to 35.3%) by the Cumulative Frailty Index, 36.4% (95% CI = 33.6% to 39.3%) by the Study of Osteoporotic Fractures (SOF) index, and 46.3% (95% CI = 40.1% to 52.4%) by the Clinical Frailty Scale (p < 0.01). Subgroup analysis in studies using the Fried’s phenotype tool found that frailty prevalence was increased with older age (p = 0.01) and was higher in those who were single (21.5%) than in married participants (9.0%) (p = 0.02). The study results supported a better understanding of frailty prevalence in different geographical distributions and provide references for health policy decision-making regarding preventing frailty progression in older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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