Abstract
Frailty is a dynamic status that can worsen or improve. However, changes in their frailty status that occur during hospitalization and their significance have not been comprehensively investigated. In this study, we explored the association between such changes and mortality 3 months after discharge in older adults hospitalized for acute care. In total, 257 participants (mean age 84.95 ± 5.88, 41.6% male) completed comprehensive geriatric assessments, including the Clinical Frailty Scale (CFS) at admission and discharge. Mean CFS score was 5.14 ± 1.35 at admission. CFS scores increased, indicating deteriorating frailty, in 29.2% of the participants (75/257) during hospitalization. Multiple logistic regression analysis demonstrated a positive association between increased CFS score during hospitalization and mortality (odds ratio, 2.987) independent of potential co-founding factors. This deterioration in frailty during hospitalization may be modifiable risk factor of poor prognosis in older adults who need acute care hospitalization.
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References
Wang MC, Li TC, Li CI, Liu CS, Lin WY, Lin CH, Yang CW, Yang SY, Lin CC (2019) Frailty, transition in frailty status and all-cause mortality in older adults of a Taichung community-based population. BMC Geriatr 19(1):26. https://doi.org/10.1186/s12877-019-1039-9
Liu ZY, Wei YZ, Wei LQ, Jiang XY, Wang XF, Shi Y, Hai H (2018) Frailty transitions and types of death in Chinese older adults: a population-based cohort study. Clin Interv Aging 2018(13):947–956. https://doi.org/10.2147/CIA.S157089.eCollection
Ye B, Chen H, Huang L, Ruan Y, Qi S, Guo Y, Huang Z, Sun S, Chen X, Shi Y, Gao J, Jiang Y (2020) Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study. BMC Geriatr 20(1):130. https://doi.org/10.1186/s12877-020-01530-x
Landré B, Aegerter P, Zins M, Goldberg M, Ankri J, Herr M (2019) Association between hospitalization and change of frailty status in the GAZEL cohort. J Nutr Health Aging 23(5):466–473. https://doi.org/10.1007/s12603-019-1186-x
Huang CH, Hsu CC, Yu PC, Peng LN, Lin MH, Chen LK (2021) Hospitalization-associated muscle weakness and functional outcomes among oldest old patients: a hospital-based cohort study. Exp Gerontol 150:111353. https://doi.org/10.1016/j.exger.2021.111353
Kim B, Hunt M, Muscedere J, Maslove DM, Lee J (2021) Using consumer-grade physical activity trackers to measure frailty transitions in older critical care survivors: exploratory observational study. JMIR Aging 4(1):e19859. https://doi.org/10.2196/19859
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383. https://doi.org/10.1016/0021-9681(87)90171-8
Rubenstein LZ, Harker JO, Salvà A, Guigoz Y, Vellas B (2001) Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 56(6):M366–M372. https://doi.org/10.1093/gerona/56.6.m366
Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel index. Md State Med J 41:61–65
Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9(3):179–186
Yesavage JA (1986) The use of self-rating depression scales in the elderly. In: Poon LW (ed) Clinical memory assessment of older adults. American Psychological Association, Washington, DC
Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A (2005) A global clinical measure of fitness and frailty in elderly people. CMAJ 173(5):489–495. https://doi.org/10.1503/cmaj.050051
Chia-Hui Chen C, Yang YT, Lai IR, Lin BR, Yang CY, Huang J, Tien YW, Chen CN, Lin MT, Liang JT, Li HC, Huang GH, Inouye SK (2019) Three nurse-administered protocols reduce nutritional decline and frailty in older gastrointestinal surgery patients: a cluster randomized trial. J Am Med Dir Assoc 20(5):524-529.e3. https://doi.org/10.1016/j.jamda.2018.09.016
Rezaei-Shahsavarloo Z, Atashzadeh-Shoorideh F, Gobbens RJJ, Ebadi A, Ghaedamini HG (2020) The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis. BMC Geriatr 20(1):526. https://doi.org/10.1186/s12877-020-01935-8
Church S, Rogers E, Rockwood K, Theou O (2020) A scoping review of the clinical frailty scale. BMC Geriatr 20(1):393. https://doi.org/10.1186/s12877-020-01801-7
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We thank the participants and staff members who helped with the current study.
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This work was supported by JSPS KAKENHI (grant numbers JP21H02826).
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HU formed the research question. All authors contributed to data collection. MN coded the data. HU conducted the analysis with input from MN, HK, KW, YY, TS, TT, and SM. HU wrote the manuscript and MN, HK, KW. YY, TS, TT, and SM reviewed the article. All authors approved the final draft.
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The authors declare there are no conflicts of interest. Sponsor played no roles.
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The study protocol was approved by our university's Ethics Committee (Graduate School of Medicine, Nagoya University, approval no. 2019-0260).
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Informed consent was obtained from all subjects prior to enrollment in the study.
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Umegaki, H., Nagae, M., Komiya, H. et al. Association between changes in frailty during hospitalization in older adults and 3-month mortality after discharge. Eur Geriatr Med 13, 1403–1406 (2022). https://doi.org/10.1007/s41999-022-00704-7
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DOI: https://doi.org/10.1007/s41999-022-00704-7