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Frailty index and its relation to falls and overnight hospitalizations in elderly Chinese people: A population-based study

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The journal of nutrition, health & aging

Abstract

Objectives

To investigate current status of frailty index (FI) defined as deficit accumulation and its relations to falls and overnight hospitalizations in an elderly Chinese population.

Design

A cross-sectional cohort study.

Setting

All of the 31 valiages in Jiang’an township, a typical medium-sized township in Rugao city, China.

Participants

Overall 1773 participants aged 70-84 years were randomly recruited.

Measurements

A FI including symptoms, activities of daily living, co-morbidities, cognitive and psychological function was constructed using 45 health deficits.

Results

The mean of FI was 0.14 in men and 0.19 in women. According to a usual FI cut-point of 0.25, 8.2% of men and 23.2% of women were classified as frail. Literate participants had lower levels of FI than their illiterate counterpart. In men, the FI was positively related to age (r = 0.186, p<.001), with a mean rate of deficit accumulation of 0.032 (on a log scale) per year. Each increment of 0.01 on the FI was associated with significantly increased risks of falls and overnight hospitalizations, with odds ratios of 1.05 (95% CI: 1.03, 1.07) and 1.05 (95% CI: 1.03, 1.08). Similarly, the aforementioned associations were observed in women. Education level moderated the associations of FI with falls in men and women.

Conclusion

Elderly Chinese women were more frail than men. The FI significantly increased with chronological age and was significantly associated with falls and overnight hospitalizations, and education level may play an important role. This study provides preliminary but crucial evidences for future researches on frailty in China.

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References

  1. Clegg A, Young J, Iliffe S, Rikkert MO & Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762.

    Article  PubMed  Google Scholar 

  2. Goldstein J, Hubbard R, Moorhouse P & Andrew M. Feasibility of using information derived from a care partner to develop a frailty index based on comprehensive geriatric assessment. The Journal of frailty & aging. 2013;2:15–21.

    CAS  Google Scholar 

  3. Oubaya N, Mahmoudi R, Jolly D, et al. Screening for frailty in elderly subjects living at home: validation of the Modified Short Emergency Geriatric Assessment (SEGAm) instrument. The journal of nutrition, health & aging. 2014;18:757–764.

    Article  CAS  Google Scholar 

  4. Rockwood K & Mitnitski A. Frailty in relation to the accumulation of deficits. The journals of gerontology Series A, Biological sciences and medical sciences. 2007;62:722–727.

    Article  PubMed  Google Scholar 

  5. Searle SD, Mitnitski A, Gahbauer EA, Gill TM & Rockwood K. A standard procedure for creating a frailty index. BMC geriatrics. 2008;8:24.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Kulminski AM, Ukraintseva SV, Kulminskaya IV, Arbeev KG, Land K & Yashin AI. Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2008;56:898–903.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sanders JL, Boudreau RM, Fried LP, Walston JD, Harris TB & Newman AB. Measurement of organ structure and function enhances understanding of the physiological basis of frailty: the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2011;59:1581–1588.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Karlsson MK, Magnusson H, von Schewelov T & Rosengren BE. Prevention of falls in the elderly—a review. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2013;24:747–762.

    Article  CAS  Google Scholar 

  9. Fuller GF. Falls in the elderly. American family physician. 2000;61:2159–2168, 2173–2154.

    Google Scholar 

  10. Fang X, Shi J, Song X, et al. Frailty in relation to the risk of falls, fractures, and mortality in older Chinese adults: results from the Beijing Longitudinal Study of Aging. The journal of nutrition, health & aging. 2012;16:903–907.

    Article  CAS  Google Scholar 

  11. Li G, Ioannidis G, Pickard L, et al. Frailty index of deficit accumulation and falls: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort. BMC musculoskeletal disorders. 2014;15:185.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gu D, Dupre ME, Sautter J, Zhu H, Liu Y & Yi Z. Frailty and mortality among Chinese at advanced ages. The journals of gerontology Series B, Psychological sciences and social sciences. 2009;64:279–289.

    Article  PubMed  Google Scholar 

  13. Katz S, Ford AB, Moskowitz RW, Jackson BA & Jaffe MW. Studies of illness in the aged: The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.

    Article  CAS  PubMed  Google Scholar 

  14. Imai Y & Hasegawa K. The Revised Hasegawa’s Dementia Scale (HDS-R)- Evaluation of its usefulness as a screening test ofr dementia. J Hong Kong Coll Psychiatr. 1994;4:5.

    Google Scholar 

  15. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research. 1982;17:37–49.

    Article  PubMed  Google Scholar 

  16. LANDERMAN LR, LAND KC & PIEPER CF. An Empirical Evaluation of the Predictive Mean Matching Method for Imputing Missing Values. Sociological Methods & Research. 1997;26:3–33.

    Article  Google Scholar 

  17. Song X, Mitnitski A & Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society. 2010;58:681–687.

    Article  PubMed  Google Scholar 

  18. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2005;173:489–495.

    Article  PubMed  Google Scholar 

  19. Fitten LJ. THINKING ABOUT COGNITIVE FRAILTY. The Journal of Prevention of Alzheimer’s Disease (JPAD). 2015;2:7–10.

    Google Scholar 

  20. Tang Z, Wang C, Song X, et al. Co-occurrence of cardiometabolic diseases and frailty in older Chinese adults in the Beijing Longitudinal Study of Ageing. Age and ageing. 2013;42:346–351.

    Article  PubMed  Google Scholar 

  21. Yu P, Song X, Shi J, et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Archives of gerontology and geriatrics. 2012;54:3–8.

    Article  PubMed  Google Scholar 

  22. Shi J, Yang Z, Song X, et al. Sex differences in the limit to deficit accumulation in late middle-aged and older Chinese people: results from the Beijing Longitudinal Study of Aging. The journals of gerontology Series A, Biological sciences and medical sciences. 2014;69:702–709.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Romero-Ortuno R. Frailty Index in Europeans: association with determinants of health. Geriatrics & gerontology international. 2014;14:420–429.

    Article  Google Scholar 

  24. Bergmann MM, Byers T, Freedman DS & Mokdad A. Validity of self-reported diagnoses leading to hospitalization: a comparison of self-reports with hospital records in a prospective study of American adults. American journal of epidemiology. 1998;147:969–977.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Unit of epidemiology, State Key Laboratory of Genetic Engineering and MOE Key Laboratory of Contemporary Anthropology, School of Life Sciences and Institutes of Biomedical Sciences, Fudan University, 200433, Shanghai, China

    Z. Liu & X. Wang

  2. Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 200092, Shanghai, China

    Q. Wang

  3. Key Laboratory of Arrhythmias of the Ministry of Education of China, Tongji University School of Medicine, Shanghai, 200092, China

    T. Zhi & Xiaoyan Jiang

  4. Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai, 200092, China

    T. Zhi & Xiaoyan Jiang

  5. Rugao People’s Hospital, Rugao, Jiangsu, 226500, China

    Y. Zhu, Y. Wang, Z. Wang, J. Shi, X. Xie & X. Chu

Authors
  1. Z. Liu
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  2. Q. Wang
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  3. T. Zhi
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  4. Y. Zhu
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  5. Y. Wang
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  6. Z. Wang
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  7. J. Shi
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  8. X. Xie
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  9. X. Chu
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  10. X. Wang
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  11. Xiaoyan Jiang
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Corresponding author

Correspondence to Xiaoyan Jiang.

Additional information

These authors contributed equally to this work.

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Liu, Z., Wang, Q., Zhi, T. et al. Frailty index and its relation to falls and overnight hospitalizations in elderly Chinese people: A population-based study. J Nutr Health Aging 20, 561–566 (2016). https://doi.org/10.1007/s12603-015-0625-6

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  • DOI: https://doi.org/10.1007/s12603-015-0625-6

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