Abstract
Objectives
We aimed to explore predictors of sustained transitions (those that are maintained
for an extra follow-up) between robustness and prefrailty in both directions.
Design
Longitudinal population-based cohort.
Setting and Participants
Community-dwelling Spaniards 65 years or older from the Toledo Study of Healthy Ageing.
Methods
The Fried's frailty phenotype was measured over 3 waves (2006–2009, 2011–2013, and
2014–2017). Multiple logistic regressions compared individuals following the pattern
robust-prefrail-prefrail with those who remained robust across waves, and those following
the pattern prefrail-robust-robust with those who remained prefrail, for sociodemographic,
clinical, life-habits, dependency for activities of daily living, upper and lower
extremities’ strength variables. The Fried's items of those who remained prefrail
and those who became robust were compared.
Results
Mean age was 72.3 years (95% CI: 71.8–72.8) and 57.9% (52.7%–63.0%) were women. After
multivariate adjustment, predictors (apart from age) of the sustained transition robustness-prefrailty
were as follows: number of drugs taken (odds ratio: 1.37; 95% CI: 1.14–1.65), not
declaring the amount of alcohol consumed (8.32; 1.78–38.88), and grip strength (0.92
per kg; 0.86–0.99). Predictors of the sustained transition prefrailty-robustness were
as follows: drinking alcohol (0.2; 0.05–0.83), uricemia (0.67; 0.49–0.93), number
of chair stands in 30 seconds (1.14; 1.01–1.28), and grip strength (1.12; 1.05–1.2).
Low grip strength was associated with a lower probability of regaining robustness.
Conclusions and Implications
Prediction of sustained transitions between the first stages of frailty development
can be achieved with a reduced number of variables and noting whether the Fried's
item leading to a diagnosis of prefrailty is low grip strength. Our results suggest
the need to intensify interventions on deprescription, quitting alcohol, and strengthening
of upper and lower limbs.
Keywords
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Article Info
Publication History
Published online: November 17, 2022
Accepted:
October 17,
2022
Received in revised form:
October 10,
2022
Received:
July 8,
2022
Publication stage
In Press Uncorrected ProofFootnotes
This work was supported by CIBER , Consorcio Centro de Investigación Biomédica en Red , Instituto de Salud Carlos III , Ministerio de Ciencia e Innovación .
The authors declare no conflicts of interest.
Identification
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© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
