Background: Frailty is characterized by a progressive decline in the physiological functions of multiple body systems that lead to a more vulnerable condition, which is prone to the development of various adverse events, such as falls, hospitalization, and mortality. This study aims to determine whether frailty increases mortality compared to pre-frailty and to identify variables associated with a higher risk of mortality.
Materials: Two cohorts, frail and pre-frail subjects, are evaluated according to the Fried phenotype. A complete examination of frailty, cognitive status, comorbidities and pharmacology was carried out at hospital admission and was extracted through electronic health record (EHR). Mortality was evaluated from the EHR.
Methods: Kaplan-Meier estimates of survival probability functions were calculated at two years censoring time for frail and pre-frail cohorts. The log-rank test assessed significant differences between survival probability functions. Significant variables for frailty ( < 0-05) were extracted by independent sample -test. Further selection was based on variable significance found in multivariate logistic regression discrimination between frail and pre-frail subjects. Cox regression over univariate -test-selected variables was calculated to identify variables associated with higher proportional hazard risks (HR) at two years.
Results: Frailty is associated with greater mortality at two years censoring time than pre-frailty (log-rank test, < 0.0001). Variables with significant ( < 0.05) association with mortality identified in both cohorts (HR 95% (CI in the frail cohort) are male sex (0.44 (0.29-0.66)), age (1.05 (1.01-1.09)), weight (0.98 (0.96-1.00)), and use of proton-pump inhibitors (PPIs) (0.60 (0.41-0.87)). Specific high-risk factors in the frail cohort are readmission at 30 days (0.50 (0.33-0.74)), SPPB sit and stand (0.62 (0.45-0.85)), heart failure (0.67 (0.46-0.98)), use of antiplatelets (1.80 (1.19-2.71)), and quetiapine (0.31 (0.12-0.81)). Specific high-risk factors in the pre-frail cohort are Barthel's score (120 (7.7-1700)), Pfeiffer test (8.4; (2.3-31)), Mini Nutritional Assessment (MNA) (1200 (18-88,000)), constipation (0.025 (0.0027-0.24)), falls (18,000 (150-2,200,000)), deep venous thrombosis (8400 (19-3,700,000)), cerebrovascular disease (0.01 (0.00064-0.16)), diabetes (360 (3.4-39,000)), thyroid disease (0.00099 (0.000012-0.085)), and the use of PPIs (0.062 (0.0072-0.54)), Zolpidem (0.000014 (0.0000000021-0.092)), antidiabetics (0.00015 (0.00000042-0.051)), diuretics (0.0003 (0.000004-0.022)), and opiates (0.000069 (0.00000035-0.013)).
Conclusions: Frailty is associated with higher mortality at two years than pre-frailty. Frailty is recognized as a systemic syndrome with many links to older-age comorbidities, which are also found in our study. Polypharmacy is strongly associated with frailty, and several commonly prescribed drugs are strongly associated with increased mortality. It must be considered that frail patients need coordinated attention where the diverse specialist taking care of them jointly examines the interactions between the diversity of treatments prescribed.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179017 | PMC |
| http://dx.doi.org/10.3390/jcm12093103 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Importance of Frailty in Older Adults With Benign Paroxysmal Positioning Vertigo.
J Neurol Phys Ther
November 2024
Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt Diepenbeek, Limburg, Belgium (S.P., P.M., J.S.); Department of Otorhinolaryngology and Head & Neck Surgery, School for Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, The Netherlands (S.P., R.V.D.B); Department of Otorhinolaryngology, Head and Neck Surgery ZOL Hospital, Belgium (N.L., W.L.); and Department of Nutrition and Movement Sciences, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University, The Netherlands (K.M.).
Background And Purpose: Even though Benign Paroxysmal Positioning Vertigo (BPPV) is one of the most reported vestibular disorders, its interaction with frailty and postural control in older adults is hardly or not investigated.
Methods: Thirty-seven older adults (≥65 years) with a diagnosis of BPPV (oaBPPV) (mean age 73.13 (4.
Frailty index predicts adverse short- and long-term outcomes in older adults with rib fractures.
Injury
January 2025
Brigham and Women's Hospital, Dpt. of Orthopaedic Surgery, Boston, MA, United States; Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, United States.
Background: Older adults with rib fractures pose an increasing clinical and financial burden on healthcare. Identifying and addressing the increased risk of adverse outcomes has been a key objective in geriatric co-management of surgical patients. The Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) is a useful predictor of complications and mortality in older adults, but its value in rib fracture management remains unclear.
View Article and Find Full Text PDFFrailty and comorbidity in older adults with and without diabetes and chronic leg ulcer: A cross-sectional study.
Int Wound J
January 2025
School of Nursing and Midwifery, University of Galway, Galway, Ireland.
This descriptive, cross-sectional study aimed to identify whether having a chronic leg ulcer (CLU), in addition to diabetes, contributed to frailty in individuals ≥65 years old. It also explored the associations between frailty, pre-frailty and other factors. 125 participants aged ≥65 attending outpatient clinics in Ireland were categorised into three groups: (1) diabetes-only and no CLU, (2) CLU-only and no diabetes, and (3) diabetes and CLU.
View Article and Find Full Text PDFLong-term changes in frailty and incident atrial fibrillation, heart failure, coronary heart disease, and stroke: A prospective follow-up study.
Heart Rhythm
January 2025
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China. Electronic address:
Article Synopsis
- People with frailty have a higher risk of developing atrial fibrillation (AF), and this study aimed to investigate how long-term changes in frailty influence this risk.
- The study involved over 50,000 UK Biobank participants who were assessed on their frailty levels and monitored for new cases of AF, heart failure (HF), coronary heart disease (CHD), and stroke over approximately 5 years.
- Results indicated that even small increases in frailty (ΔFI) significantly raised the risk of AF, and participants who remained frail had nearly double the risk compared to those who maintained non-frail status; however, those who improved their frailty status saw a notable decrease in risk.
Purpose: To report the prevalence and risk factors of elder self-neglect (ESN) among community-dwelling older adults ( = 604).
Method: The current cross-sectional study was conducted from July 2019 to October 2020 in Lanzhou City, China. ESN was determined by the Scale of Elderly Self-Neglect, which evaluates five dimensions: (a) medical health and care, (b) environmental sanitation and personal hygiene, (c) mental health, (d) safety, and (e) social engagement.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!