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The importance of different frailty domains in a population based sample in England

The importance of different frailty domains in a population based sample in England
The importance of different frailty domains in a population based sample in England
Background: The aim was to estimate the prevalence of frailty and relative contribution of physical/balance, nutritive, cognitive and sensory frailty to important adverse health states (falls, physical activity levels, outdoor mobility, problems in self-care or usual activities, and lack of energy or accomplishment) in an English cohort by age and sex.

Methods: analysis of baseline data from a cohort of 9803 community-dwelling participants in a clinical trial. The sample was drawn from a random selection of all people aged 70 or more registered with 63 general practices across England. Data were collected by postal questionnaire. Frailty was measured with the Strawbridge questionnaire. We used cross sectional, multivariate logistic regression to estimate the association between frailty domains and known correlates and adjusted for age. Some models were stratified by sex.

Results: mean age of participants was 78 years (sd 5.7), range 70 to 101 and 47.5% (4653/9803) were men. The prevalence of overall frailty was 20.7% (2005/9671) and there was no difference in prevalence by sex (Odds Ratio 0.98; 95% Confidence Interval 0.89 to 1.08). Sensory frailty was the most common and this was reported by more men (1823/4586) than women (1469/5056; Odds Ratio for sensory frailty 0.62, 95% Confidence Interval 0.57 to 0.68). Men were less likely than women to have physical or nutritive frailty. Physical frailty had the strongest independent associations with adverse health states. However, sensory frailty was independently associated with falls, less frequent walking, problems in self-care and usual activities, lack of energy and accomplishment.

Conclusions: physical frailty was more strongly associated with adverse health states, but sensory frailty was much more common. The health gain from intervention for sensory frailty in England is likely to be substantial, particularly for older men. Sensory frailty should be explored further as an important target of intervention to improve health outcomes for older people both at clinical and population level.
1471-2318
Arnadottir, Solveig
2753798d-d973-45e8-b16d-fe0ed6498a4c
Bruce, Julie
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Lall, Ranjit
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Withers, Emma
79c2cf59-3a1b-4dc5-a708-536bf095d024
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Shaw, Fiona
67287e85-66cd-47ab-a298-88a8b5773337
sheridan, ray
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Hossain, Anower
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Lamb, Sarah
a0e4ca9d-cb5b-4ad7-b730-d1177e6d4ca0
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Arnadottir, Solveig
2753798d-d973-45e8-b16d-fe0ed6498a4c
Bruce, Julie
9a531eb0-95e8-4dc9-a4d5-6679fe0a1315
Lall, Ranjit
2dd7769c-3fa4-43f5-942d-188f67c2bddd
Withers, Emma
79c2cf59-3a1b-4dc5-a708-536bf095d024
Underwood, Martin
239a8609-e7b5-4acb-aaf9-9e7f717f0d62
Shaw, Fiona
67287e85-66cd-47ab-a298-88a8b5773337
sheridan, ray
e4f04f51-6a2b-461e-8c70-d263364d942d
Hossain, Anower
1a312d2e-bf9e-46ca-8e4e-5d54eeae5016
Lamb, Sarah
a0e4ca9d-cb5b-4ad7-b730-d1177e6d4ca0
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Arnadottir, Solveig, Bruce, Julie, Lall, Ranjit, Withers, Emma, Underwood, Martin, Shaw, Fiona, sheridan, ray, Hossain, Anower, Lamb, Sarah and Yardley, Lucy (2020) The importance of different frailty domains in a population based sample in England. BMC Geriatrics, 20, [16]. (doi:10.1186/s12877-019-1411-9).

Record type: Article

Abstract

Background: The aim was to estimate the prevalence of frailty and relative contribution of physical/balance, nutritive, cognitive and sensory frailty to important adverse health states (falls, physical activity levels, outdoor mobility, problems in self-care or usual activities, and lack of energy or accomplishment) in an English cohort by age and sex.

Methods: analysis of baseline data from a cohort of 9803 community-dwelling participants in a clinical trial. The sample was drawn from a random selection of all people aged 70 or more registered with 63 general practices across England. Data were collected by postal questionnaire. Frailty was measured with the Strawbridge questionnaire. We used cross sectional, multivariate logistic regression to estimate the association between frailty domains and known correlates and adjusted for age. Some models were stratified by sex.

Results: mean age of participants was 78 years (sd 5.7), range 70 to 101 and 47.5% (4653/9803) were men. The prevalence of overall frailty was 20.7% (2005/9671) and there was no difference in prevalence by sex (Odds Ratio 0.98; 95% Confidence Interval 0.89 to 1.08). Sensory frailty was the most common and this was reported by more men (1823/4586) than women (1469/5056; Odds Ratio for sensory frailty 0.62, 95% Confidence Interval 0.57 to 0.68). Men were less likely than women to have physical or nutritive frailty. Physical frailty had the strongest independent associations with adverse health states. However, sensory frailty was independently associated with falls, less frequent walking, problems in self-care and usual activities, lack of energy and accomplishment.

Conclusions: physical frailty was more strongly associated with adverse health states, but sensory frailty was much more common. The health gain from intervention for sensory frailty in England is likely to be substantial, particularly for older men. Sensory frailty should be explored further as an important target of intervention to improve health outcomes for older people both at clinical and population level.

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Accepted/In Press date: 30 December 2019
Published date: 15 January 2020

Identifiers

Local EPrints ID: 439230
URI: http://eprints.soton.ac.uk/id/eprint/439230
ISSN: 1471-2318
PURE UUID: 417dc210-b555-48c6-85bb-eed272595911
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 07 Apr 2020 16:30
Last modified: 21 May 2020 00:27

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Contributors

Author: Solveig Arnadottir
Author: Julie Bruce
Author: Ranjit Lall
Author: Emma Withers
Author: Martin Underwood
Author: Fiona Shaw
Author: ray sheridan
Author: Anower Hossain
Author: Sarah Lamb
Author: Lucy Yardley ORCID iD

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