Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Measurement of the Frailty Syndrome
2.2. Anthropometry Measurements
2.3. Measurement of Other Covariates
2.4. Statistical Analysis
3. Results
3.1. Sociodemographic Characteristics
3.2. Factors Associated with the Frailty Syndrome
3.3. Predictors of the Frailty Syndrome
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total (n = 301) | Male (n = 92), 30.6% | Female (n = 209), 69.4% |
---|---|---|---|
Age (years) | 67.1 ± 5.5 | 67.2 ± 5.5 | 67.0 ± 5.6 |
Ethnic groups | |||
Malay | 213 (70.8) | 65 (70.7) | 148 (70.8) |
Chinese | 37 (12.3) | 14 (15.2) | 23 (11.0) |
Indian | 51 (16.9) | 13 (14.1) | 38 (18.2) |
Marital status | |||
Single/Divorced/Widow/Widower | 142 (47.2) | 18 (19.6) | 124 (59.3) |
Married | 159 (52.8) | 74 (80.4) | 85 (40.7) |
Educational level | |||
No formal education | 38 (12.6) | 4 (4.3) | 34 (16.3) |
Formal education | 263 (87.4) | 88 (95.7) | 175 (83.7) |
Living arrangement | |||
Living alone | 37 (12.3) | 9 (9.8) | 28 (13.4) |
Living with others | 264 (87.7) | 83 (90.2) | 181 (86.6) |
Monthly household income (RM), mean (median, IQR) | 959.9 | 1307.6 | 806.9 |
(800.0, 700.0) | (1000.0, 1100.0) | (600.0, 650.0) | |
Monthly household income classification (RM) | |||
≤970 | 178 (59.1) | 38 (41.3) | 140 (67.0) |
>970 | 123 (40.9) | 54 (58.7) | 69 (33.0) |
Occupational status | |||
Not working/Retired | 228 (75.7) | 63 (68.5) | 165 (78.9) |
Still working | 82 (27.2) | 29 (31.5) | 44 (21.1) |
Functional ability | |||
Normal functional ability | 146 (48.5) | 55 (59.8) | 91 (43.5) |
Functional disability | 155 (51.5) | 37 (40.2) | 118 (56.5) |
Cognitive status | |||
Normal | 256 (85.0) | 87 (94.6) | 169 (80.9) |
Cognitive impairment | 45 (15.0) | 5 (5.4) | 40 (19.1) |
Depressive symptoms | |||
Normal | 223 (74.1) | 69 (75.0) | 154 (73.7) |
Depressive symptoms | 78 (25.9) | 23 (25.0) | 55 (26.3) |
Body mass index (kgm−2) | 27.5 ± 5.5 | 26.2 ± 4.9 | 28.1 ± 5.6 |
Body part circumference (cm) | |||
Waist circumference | 92.1 ± 13.4 | 92.4 ± 11.9 | 92.0 ± 14.0 |
Mid-upper arm circumference | 29.7 ± 4.2 | 29.7 ± 4.1 | 29.7 ± 4.3 |
Calf circumference | 34.3 ± 4.6 | 34.8 ± 4.3 | 34.1 ± 4.7 |
Body composition | |||
Body fat percentage (%) | 36.1 ± 6.5 | 29.1 ± 5.1 | 39.2 ± 4.3 |
Skeletal muscle mass (kg) | 28.1 ± 7.8 | 22.6 ± 4.9 | 30.5 ± 7.6 |
Skeletal muscle index (kgm−2) | 12.0 ± 3.8 | 8.6 ± 2.0 | 13.5 ± 3.4 |
Biochemical parameters | |||
Hemoglobin | 13.3 ± 1.5 | 14.2 ± 1.6 | 12.9 ± 1.2 |
Albumin | 43.1 ± 2.1 | 43.0 ± 2.2 | 43.1 ± 2.1 |
Fasting blood glucose | 6.9 ± 3.2 | 6.9 ± 3.6 | 6.8 ± 3.0 |
HbA1c | 55.6 ± 22.5 | 56.8 ± 24.6 | 55.2 ± 21.5 |
Total cholesterol | 5.3 ± 1.1 | 4.9 ± 1.1 | 5.5 ± 1.1 |
High Density Lipoprotein | 1.4 ± 0.3 | 1.2 ± 0.2 | 1.5 ± 0.3 |
Low Density Lipoprotein | 3.2 ± 1.1 | 3.1 ± 1.1 | 3.3 ± 1.1 |
Triglyceride | 1.7 ± 0.9 | 1.8 ± 1.0 | 1.6 ± 0.8 |
C-reactive protein | 4.8 ± 7.3 | 5.1 ± 10.8 | 4.6 ± 5.1 |
Characteristics | Robust (n = 34) | Pre-Frail (n = 219) | Frail (n = 48) | χ2/r | p-Value |
---|---|---|---|---|---|
Age (year) | 63.9 ± 3.3 | 67.05 ± 5.3 | 69.4 ± 6.6 | 0.265 c | 0.000 *** |
Age groups (year) | 12.482 a | 0.002 ** | |||
60–69 | 31 (91.2) | 161 (73.5) | 27 (56.3) | ||
70 or above | 3 (8.8) | 58 (26.5) | 21 (43.8) | ||
Gender | 4.285 a | 0.117 | |||
Male | 15 (44.1) | 66 (30.1) | 11 (22.9) | ||
Female | 19 (55.9) | 153 (69.9) | 37 (77.1) | ||
Marital status | 9.036 a | 0.011 * | |||
Married | 23 (67.6) | 119 (54.3) | 17 (35.4) | ||
Single/Divorced/Widowed | 11 (32.4) | 100 (45.7) | 31 (64.6) | ||
Educational level | 7.612 a | 0.022 * | |||
No formal education | 1 (2.9) | 26 (11.9) | 11 (22.9) | ||
Formal education | 33 (97.1) | 193 (88.1) | 37 (77.1) | ||
Monthly household income (RM) | 1366.5 ± 899.0 | 942.2 ± 764.0 | 678.1 ± 497.5 | −0.250 c | 0.000 *** |
Presence of chronic diseases | 7.606 | 0.023 * | |||
None | 14 (41.2) | 68 (31.1) | 7 (14.6) | ||
≥1 chronic disease | 20 (58.8) | 151 (68.9) | 41 (85.4) | ||
Functional status | 11.821 | 0.003 ** | |||
Functional disability | 13 (38.2) | 107 (48.9) | 35 (72.9) | ||
Normal functional ability | 21 (61.8) | 112 (51.1) | 43 (27.1) | ||
Cognitive status | 13.550 | 0.001 ** | |||
Normal | 28 (82.4) | 190 (86.6) | 31 (64.6) | ||
Cognitive impairment | 6 (17.6) | 29 (13.2) | 17 (35.4) | ||
Depressive symptoms | 4.193 | 0.123 | |||
Normal | 27 (79.4) | 166 (75.8) | 30 (62.5) | ||
Depressive symptoms | 7 (20.6) | 53 (24.2) | 18 (37.5) | ||
BMI (kgm−2) | 12.000 b | 0.006 ** | |||
Underweight | 1 (2.9) | 2 (0.9) | 5 (10.4) | ||
Normal | 14 (41.2) | 69 (31.5) | 14 (29.2) | ||
Overweight/Obesity | 19 (55.9) | 148 (67.6) | 29 (60.4) | ||
Mid-upper arm circumference (cm) | 7.824 b | 0.012 * | |||
Normal | 34 (100.0) | 217 (99.1) | 45 (93.8) | ||
Muscle wasting | 0 (0.00) | 2 (0.9) | 3 (6.3) | ||
Biochemical parameters | |||||
Hemoglobin | 13.8 ± 1.5 | 13.2 ± 1.5 | 13.2 ± 1.3 | −0.167 | 0.004 ** |
C-reactive protein | 4.9 ± 6.2 | 3.3 ± 1.1 | 5.1 ± 7.9 | 0.090 b | 0.019 * |
Characteristics | Frail | Pre-Frail | ||||
---|---|---|---|---|---|---|
OR | CI | OR | CI | OR | CI | |
Sociodemographic factors | ||||||
Age | 1.319 | (1.157–1.505) | 0.000 | 1.214 | (1.078–1.329) | 0.001 |
Household income | 0.999 | (0.998–1.000) | 0.029 | 1.000 | (0.999–1.000) | 0.441 |
Malnutrition | ||||||
Malnourished | 4.551 | (1.425–14.532) | 0.011 | 1.733 | (0.658–4.567) | 0.226 |
Well-nourished | Reference | |||||
Anthropometric measurements | ||||||
Waist circumference | 1.042 | (0.976–1.112) | 0.218 | 1.007 | (0.958–1.05) | 0.797 |
Calf circumference | 0.969 | (0.839–1.131 | 0.691 | 1.006 | (0.890–1.137) | 0.797 |
Mid-upper Arm circumference | 1.076 | (0.888–1.304) | 0.454 | 1.037 | (0.898–1.198) | 0.619 |
Body composition | ||||||
Body fat percentage | 0.889 | (0.803–1.007) | 0.065 | 0.952 | (0.878–1.033) | 0.237 |
Low skeletal muscle mass | 1.439 | (1.185–1.748) | 0.001 | 1.269 | (1.089–1.478) | 0.026 |
Visceral fat | 1.016 | (0.956–1.079) | 0.646 | 1.016 | (0.890–1.137) | 0.922 |
Blood parameters | ||||||
Total cholesterol | 1.461 | (0.343–6.233) | 0.608 | 0.449 | (0.143– 1.406) | 0.169 |
High-density lipoprotein | 2.2568 | (0.294–17.329) | 0.434 | 3.300 | (0.624–17.456) | 0.160 |
Low-density lipoprotein | 1.020 | (0.980–1.020) | 0.980 | 2.820 | (0.836–9.509) | 0.0.95 |
C-reactive protein | 1.159 | (0.205–0.981) | 0.046 | 0.993 | (0.476–2.072) | 0.984 |
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Norazman, C.W.; Adznam, S.N.; Jamaluddin, R. Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia. Int. J. Environ. Res. Public Health 2020, 17, 6549. https://doi.org/10.3390/ijerph17186549
Norazman CW, Adznam SN, Jamaluddin R. Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia. International Journal of Environmental Research and Public Health. 2020; 17(18):6549. https://doi.org/10.3390/ijerph17186549
Chicago/Turabian StyleNorazman, Camilla Wahida, Siti Nur’Asyura Adznam, and Rosita Jamaluddin. 2020. "Physical Frailty among Urban-Living Community-Dwelling Older Adults in Malaysia" International Journal of Environmental Research and Public Health 17, no. 18: 6549. https://doi.org/10.3390/ijerph17186549