Abstract
Background
Original Fried's frailty criteria have not demonstrated their prognostic validity
of mortality, disability and mobility loss in European cohorts.
Objectives
To analyze whether frailty implies increased risk of death, incident disability in
basic (BADL) or instrumental (IADL) activities of daily living, or mobility impairment.
Design
Concurrent cohort study.
Setting
Albacete City, Spain.
Participants
993 participants over age 70 from the FRADEA Study.
Measurements
Mortality, BADL and mobility using the Barthel Index, and IADL using the Lawton IADL
Index, were recorded. BADL disability was defined as loss of the ability to perform
bathing, grooming, dressing, toilet use, or feeding, while deterioration of mobility
was defined as loss of ability to perform transfers, walk, or use stairs, and IADL
disability as losing any of the activities included in the Lawton Index. The risk
of presenting adverse events was determined by Cox and Kaplan–Meier proportional hazard
analysis and logistic regression adjusted for age, sex, function, and comorbidity.
Results
Mean follow-up was 534 days (SD 153), during which 105 participants (10.6%) died.
Mean time to death was 363 days (SD 218), while 192 (25.4%) lost at least one BADL,
492 (60%) at least one IADL, and 222 (28.9%) lost mobility. Frail subjects had a greater
adjusted risk of death (HR 5.5, CI 95% 1.5–20.2), of losing BADL (HR 2.5, CI 95% 1.3–4.8),
of losing mobility (HR 2.7, CI 95% 1.5–5.0), and of losing IADL (HR 1.9, CI 95% 1.1–3.3)
than non-frail patients.
Conclusion
Fried's frailty criteria are associated with death, incident disability, and mobility
impairment in a Spanish cohort of older adults.
Keywords
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Article info
Publication history
Published online: October 16, 2012
Accepted:
September 28,
2012
Received in revised form:
September 25,
2012
Received:
August 2,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
