Abstract
Objective
The objective of this study was to evaluate, among nursing home residents, the extent
to which the various operational definitions of frailty predict mortality and falls
at 1 year.
Methods
We studied 662 participants from the Sample of Elderly Nursing home Individuals: An
Observational Research (SENIOR) cohort aged 83.2 ± 8.99 years, including 484 (72.5%)
women and living in nursing homes. Among this cohort, 584 and 565 participants, respectively,
were monitored over 12 months for mortality assessment and for occurrence of falls
(ie, by mean of their medical records). Each patient was subjected to a clinical examination
at baseline, during which many original clinical characteristics were collected. Stepwise
regression analyses were carried out to predict mortality and falls.
Results
Among the participants included in the study, 93 (15.9%) died and 211 (37.3%) experienced
a fall during the 1-year of follow-up. After adjustment, none of the definitions of
frailty assessed predicted the 1-year occurrence of negative health outcomes. When
comparing the clinical characteristics of deceased participants and those still alive,
being a man (OR = 1.89; 95% CI: 1.19-3.01; P = .002) and being diagnosed with sarcopenia (OR = 1.7; 95% CI: 1.1-2.92; P = .03) were independent factors associated with 1-year mortality. Other independent
factors that were significantly associated with the 1-year occurrence of falls were
the results obtained with the Tinetti test (OR = 0.93; 95% CI: 0.87-0.98; P = .04), with the grip strength test (OR = 0.95; 95% CI: 0.90-0.98, P = .03), and with the isometric strength test of elbow extensors (OR = 0.93; 95%CI:
0.87-0.97; P = .04).
Conclusions
Within the operational definitions of frailty assessed, none is sufficiently sensitive
to predict the occurrence of falls and deaths at 1 year among nursing home residents.
Globally, the frequency of undesirable health outcomes seems to be higher among participants
with lower muscle strength and mobility. Medical strategy or adapted physical activity,
with the aim of improving specific isometric muscle strength and mobility could potentially,
but significantly, reduce the occurrence of falls and even deaths.
Keywords
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Article info
Publication history
Published online: July 28, 2017
Footnotes
Fanny Buckinx is supported by a Fellowship from the FNRS (Fonds National de la Recherche Scientifique de Belgique — FRSFNRS. www.frs-fnrs.be).
The authors declare no conflicts of interest.
Identification
Copyright
© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
