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Frailty and Aging

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (1 December 2020) | Viewed by 38042

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Dr. Scott Kehler

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1. Faculty of Health, School of Physiotherapy, Dalhousie University, Halifax, NS B3H 4R2, Canada
2. Division of Geriatric Medicine, Dalhousie University, Halifax, NS B2N4H5, Canada
Interests: frailty; physical activity; sedentary behavior; rehabilitation; cardiovascular disease

Special Issue Information

Dear Colleagues,

As people grow older, they are more likely to develop health problems. However, people acquire them at different rates as they grow older. The concept of frailty is a way to understand vulnerability to and heterogeneity in the accumulation of health problems with age. People who are frailer have more age-related health problems compared with people who are less frail. Research studies consistently show that individuals with high degrees of frailty have a poor quality of life and are at a greater risk of being hospitalized, to have a fall, and die prematurely compared to those with lower frailty levels. Indeed, it will be important to understand the ways in which frailty can be effectively managed or ideally prevented. In this Special Issue of “Frailty and Aging”, we welcome original research to provide a better understanding of the clinical and epidemiological aspects of frailty. We are especially interested in how different exposures, whether related to health behaviours (e.g., physical activity, sedentary behaviour, or diet), healthcare environments (e.g., hospital settings), stressors (e.g., surgery), social vulnerability, or health equity impact frailty and its associated outcomes.

Dr. Scott Kehler
Guest Editor

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Keywords

frailty
aging
geriatrics
preventive factors
health behaviors
hospitalization
socioeconomic factors
risk factors
prognosis

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Published Papers (4 papers)

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Research

11 pages, 1275 KiB

Open AccessArticle

Translation, Reliability and Validity of the Spanish Version of the Modified New Mobility Score (NMS-ES)

by Rafael Prieto-Moreno, Patrocinio Ariza-Vega, Mariana Ortiz-Piña, Maureen C. Ashe, Dulce Romero-Ayuso and Morten Tange Kristensen

Int. J. Environ. Res. Public Health 2021, 18(2), 723; https://doi.org/10.3390/ijerph18020723 - 15 Jan 2021

Cited by 3 | Viewed by 3068

Abstract

The New Mobility Score (NMS) is an easy to administer self-report measure of functional ability, and is used worldwide as a hip fracture (HF) score, but a Spanish version does not exist. The aim of the study is to translate NMS into Spanish, and to measure its inter-rater reliability, internal consistency, and concurrent validity in a sample of Spanish speaking patients with HF. A reliability and validity study with a sample of 60 adults, 65 years or older (46 women and 14 men; mean age 81.7 years) with a hip fracture admitted consecutively to the acute trauma service of the Health Campus Hospital of Granada. The participants were interviewed during the first week after surgery by an occupational therapist or a physiotherapist. The statistical test used for analysis were: Cronbach’s α coefficient, McNemar–Bowker test, Bland–Altman plot, Spearman´s Rho, and Mann–Whitney U test. The Cronbach’s α coefficient was 0.90. No inter-rater systematic differences were found. We noted significant associations between the Spanish Version of the Modified New Mobility Score (NMS-ES) and selected health outcomes: Age, cognition, pre-fracture function, and basic mobility. The NMS-ES is a reliable and valid instrument to assess pre-injury functional levels for patients with HF in Spanish speaking countries. Full article

(This article belongs to the Special Issue Frailty and Aging)

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17 pages, 3202 KiB

Open AccessArticle

Assessing Global Frailty Scores: Development of a Global Burden of Disease-Frailty Index (GBD-FI)

by Mark O’Donovan, Duygu Sezgin, Zubair Kabir, Aaron Liew and Rónán O’Caoimh

Int. J. Environ. Res. Public Health 2020, 17(16), 5695; https://doi.org/10.3390/ijerph17165695 - 6 Aug 2020

Cited by 7 | Viewed by 9852

Abstract

Frailty is an independent age-associated predictor of morbidity and mortality. Despite this, many countries lack population estimates with large heterogeneity between studies. No population-based standardised metric for frailty is available. We applied the deficit accumulation model of frailty to create a frailty index (FI) using population-level estimates from the Global Burden of Disease (GBD) 2017 study across 195 countries to create a novel GBD frailty index (GBD-FI). Standard FI criteria were applied to all GBD categories to select GBD-FI items. Content validity was assessed by comparing the GBD-FI with a selection of established FIs. Properties including the rate of deficit accumulation with age were examined to assess construct validity. Linear regression models were created to assess if mean GBD-FI scores predicted one-year incident mortality. From all 554 GBD items, 36 were selected for the GBD-FI. Face validity against established FIs was variable. Characteristic properties of a FI—higher mean score for females and a deficit accumulation rate of approximately 0.03 per year, were observed. GBD-FI items were responsible for 19% of total Disability-Adjusted Life Years for those aged ≥70 years in 2017. Country-specific mean GBD-FI scores ranged from 0.14 (China) to 0.19 (Hungary) and were a better predictor of mortality from non-communicable diseases than age, gender, Healthcare Access and Quality Index or Socio-Demographic Index scores. The GBD-FI is a valid measure of frailty at population-level but further external validation is required. Full article

(This article belongs to the Special Issue Frailty and Aging)

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13 pages, 1736 KiB

Open AccessArticle

Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

by Jiraporn Chittrakul, Penprapa Siviroj, Somporn Sungkarat and Ratana Sapbamrer

Int. J. Environ. Res. Public Health 2020, 17(9), 3102; https://doi.org/10.3390/ijerph17093102 - 29 Apr 2020

Cited by 71 | Viewed by 20874

Abstract

Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population. Full article

(This article belongs to the Special Issue Frailty and Aging)

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9 pages, 852 KiB

Open AccessArticle

A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

by Tan Van Nguyen, Thuy Thanh Ly and Tu Ngoc Nguyen

Int. J. Environ. Res. Public Health 2020, 17(5), 1582; https://doi.org/10.3390/ijerph17051582 - 29 Feb 2020

Cited by 6 | Viewed by 3334

Abstract

Background. The Clinical Frailty Scale (CFS) is gaining increasing acceptance due to its simplicity and applicability. Aims. This pilot study aims to examine the role of CFS in identifying the prevalence of frailty, frailty transition, and the impact of frailty on readmission after discharge in older hospitalized patients. Methods. Patients aged ≥60 admitted to the geriatric ward of a hospital in Vietnam were recruited from 9/2018–3/2019 and followed for three months. Frailty was assessed before discharge and after three months, using the CFS (robust: score 1–2, pre-frail: 3–4, and frail: ≥5). Multivariate logistic regression was applied to investigate the associated factors of frailty transition and the impact of frailty on readmission. Results. There were 364 participants, mean age 74.9, 58.2% female. At discharge, 4 were robust, 160 pre-frail, 200 frail. Among the 160 pre-frail participants at discharge, 124 (77.5%) remained pre-frail, and 36 (22.5%) became frail after 3 months. Age (adjusted OR1.09, 95% CI 1.03–1.16), number of chronic diseases (adjusted OR 1.37, 95% CI 1.03–1.82), and polypharmacy at discharge (adjusted OR 3.68, 95% CI 1.15–11.76) were significant predictors for frailty after 3 months. A frailty status at discharge was significantly associated with increased risk of readmission (adjusted OR2.87, 95% CI 1.71–4.82). Conclusions. Frailty was present in half of the participants and associated with increased risk of readmission. This study suggests further studies to explore the use of the CFS via phone calls for monitoring patients’ frailty status after discharge, which may be helpful for older patients living in rural and remote areas. Full article

(This article belongs to the Special Issue Frailty and Aging)

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