Skip to main content
Top
Published in: The journal of nutrition, health & aging 5/2016

01-05-2016

Frailty index and its relation to falls and overnight hospitalizations in elderly Chinese people: A population-based study

Authors: Z. Liu, Q. Wang, T. Zhi, Y. Zhu, Y. Wang, Z. Wang, J. Shi, X. Xie, X. Chu, X. Wang, Xiaoyan Jiang

Published in: The journal of nutrition, health & aging | Issue 5/2016

Login to get access

Abstract

Objectives

To investigate current status of frailty index (FI) defined as deficit accumulation and its relations to falls and overnight hospitalizations in an elderly Chinese population.

Design

A cross-sectional cohort study.

Setting

All of the 31 valiages in Jiang’an township, a typical medium-sized township in Rugao city, China.

Participants

Overall 1773 participants aged 70-84 years were randomly recruited.

Measurements

A FI including symptoms, activities of daily living, co-morbidities, cognitive and psychological function was constructed using 45 health deficits.

Results

The mean of FI was 0.14 in men and 0.19 in women. According to a usual FI cut-point of 0.25, 8.2% of men and 23.2% of women were classified as frail. Literate participants had lower levels of FI than their illiterate counterpart. In men, the FI was positively related to age (r = 0.186, p<.001), with a mean rate of deficit accumulation of 0.032 (on a log scale) per year. Each increment of 0.01 on the FI was associated with significantly increased risks of falls and overnight hospitalizations, with odds ratios of 1.05 (95% CI: 1.03, 1.07) and 1.05 (95% CI: 1.03, 1.08). Similarly, the aforementioned associations were observed in women. Education level moderated the associations of FI with falls in men and women.

Conclusion

Elderly Chinese women were more frail than men. The FI significantly increased with chronological age and was significantly associated with falls and overnight hospitalizations, and education level may play an important role. This study provides preliminary but crucial evidences for future researches on frailty in China.
Appendix
Available only for authorised users
Literature
1.
go back to reference Clegg A, Young J, Iliffe S, Rikkert MO & Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762.CrossRefPubMed Clegg A, Young J, Iliffe S, Rikkert MO & Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762.CrossRefPubMed
2.
go back to reference Goldstein J, Hubbard R, Moorhouse P & Andrew M. Feasibility of using information derived from a care partner to develop a frailty index based on comprehensive geriatric assessment. The Journal of frailty & aging. 2013;2:15–21. Goldstein J, Hubbard R, Moorhouse P & Andrew M. Feasibility of using information derived from a care partner to develop a frailty index based on comprehensive geriatric assessment. The Journal of frailty & aging. 2013;2:15–21.
3.
go back to reference Oubaya N, Mahmoudi R, Jolly D, et al. Screening for frailty in elderly subjects living at home: validation of the Modified Short Emergency Geriatric Assessment (SEGAm) instrument. The journal of nutrition, health & aging. 2014;18:757–764.CrossRef Oubaya N, Mahmoudi R, Jolly D, et al. Screening for frailty in elderly subjects living at home: validation of the Modified Short Emergency Geriatric Assessment (SEGAm) instrument. The journal of nutrition, health & aging. 2014;18:757–764.CrossRef
4.
go back to reference Rockwood K & Mitnitski A. Frailty in relation to the accumulation of deficits. The journals of gerontology Series A, Biological sciences and medical sciences. 2007;62:722–727.CrossRefPubMed Rockwood K & Mitnitski A. Frailty in relation to the accumulation of deficits. The journals of gerontology Series A, Biological sciences and medical sciences. 2007;62:722–727.CrossRefPubMed
6.
go back to reference Kulminski AM, Ukraintseva SV, Kulminskaya IV, Arbeev KG, Land K & Yashin AI. Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2008;56:898–903.CrossRefPubMedPubMedCentral Kulminski AM, Ukraintseva SV, Kulminskaya IV, Arbeev KG, Land K & Yashin AI. Cumulative deficits better characterize susceptibility to death in elderly people than phenotypic frailty: lessons from the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2008;56:898–903.CrossRefPubMedPubMedCentral
7.
go back to reference Sanders JL, Boudreau RM, Fried LP, Walston JD, Harris TB & Newman AB. Measurement of organ structure and function enhances understanding of the physiological basis of frailty: the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2011;59:1581–1588.CrossRefPubMedPubMedCentral Sanders JL, Boudreau RM, Fried LP, Walston JD, Harris TB & Newman AB. Measurement of organ structure and function enhances understanding of the physiological basis of frailty: the Cardiovascular Health Study. Journal of the American Geriatrics Society. 2011;59:1581–1588.CrossRefPubMedPubMedCentral
8.
go back to reference Karlsson MK, Magnusson H, von Schewelov T & Rosengren BE. Prevention of falls in the elderly—a review. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2013;24:747–762.CrossRef Karlsson MK, Magnusson H, von Schewelov T & Rosengren BE. Prevention of falls in the elderly—a review. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2013;24:747–762.CrossRef
9.
go back to reference Fuller GF. Falls in the elderly. American family physician. 2000;61:2159–2168, 2173–2154. Fuller GF. Falls in the elderly. American family physician. 2000;61:2159–2168, 2173–2154.
10.
go back to reference Fang X, Shi J, Song X, et al. Frailty in relation to the risk of falls, fractures, and mortality in older Chinese adults: results from the Beijing Longitudinal Study of Aging. The journal of nutrition, health & aging. 2012;16:903–907.CrossRef Fang X, Shi J, Song X, et al. Frailty in relation to the risk of falls, fractures, and mortality in older Chinese adults: results from the Beijing Longitudinal Study of Aging. The journal of nutrition, health & aging. 2012;16:903–907.CrossRef
11.
go back to reference Li G, Ioannidis G, Pickard L, et al. Frailty index of deficit accumulation and falls: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort. BMC musculoskeletal disorders. 2014;15:185.CrossRefPubMedPubMedCentral Li G, Ioannidis G, Pickard L, et al. Frailty index of deficit accumulation and falls: data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) Hamilton cohort. BMC musculoskeletal disorders. 2014;15:185.CrossRefPubMedPubMedCentral
12.
go back to reference Gu D, Dupre ME, Sautter J, Zhu H, Liu Y & Yi Z. Frailty and mortality among Chinese at advanced ages. The journals of gerontology Series B, Psychological sciences and social sciences. 2009;64:279–289.CrossRefPubMed Gu D, Dupre ME, Sautter J, Zhu H, Liu Y & Yi Z. Frailty and mortality among Chinese at advanced ages. The journals of gerontology Series B, Psychological sciences and social sciences. 2009;64:279–289.CrossRefPubMed
13.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA & Jaffe MW. Studies of illness in the aged: The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.CrossRefPubMed Katz S, Ford AB, Moskowitz RW, Jackson BA & Jaffe MW. Studies of illness in the aged: The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–919.CrossRefPubMed
14.
go back to reference Imai Y & Hasegawa K. The Revised Hasegawa’s Dementia Scale (HDS-R)- Evaluation of its usefulness as a screening test ofr dementia. J Hong Kong Coll Psychiatr. 1994;4:5. Imai Y & Hasegawa K. The Revised Hasegawa’s Dementia Scale (HDS-R)- Evaluation of its usefulness as a screening test ofr dementia. J Hong Kong Coll Psychiatr. 1994;4:5.
15.
go back to reference Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research. 1982;17:37–49.CrossRefPubMed Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research. 1982;17:37–49.CrossRefPubMed
16.
go back to reference LANDERMAN LR, LAND KC & PIEPER CF. An Empirical Evaluation of the Predictive Mean Matching Method for Imputing Missing Values. Sociological Methods & Research. 1997;26:3–33.CrossRef LANDERMAN LR, LAND KC & PIEPER CF. An Empirical Evaluation of the Predictive Mean Matching Method for Imputing Missing Values. Sociological Methods & Research. 1997;26:3–33.CrossRef
17.
go back to reference Song X, Mitnitski A & Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society. 2010;58:681–687.CrossRefPubMed Song X, Mitnitski A & Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society. 2010;58:681–687.CrossRefPubMed
18.
go back to reference Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2005;173:489–495.CrossRefPubMed Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne. 2005;173:489–495.CrossRefPubMed
19.
go back to reference Fitten LJ. THINKING ABOUT COGNITIVE FRAILTY. The Journal of Prevention of Alzheimer’s Disease (JPAD). 2015;2:7–10. Fitten LJ. THINKING ABOUT COGNITIVE FRAILTY. The Journal of Prevention of Alzheimer’s Disease (JPAD). 2015;2:7–10.
20.
go back to reference Tang Z, Wang C, Song X, et al. Co-occurrence of cardiometabolic diseases and frailty in older Chinese adults in the Beijing Longitudinal Study of Ageing. Age and ageing. 2013;42:346–351.CrossRefPubMed Tang Z, Wang C, Song X, et al. Co-occurrence of cardiometabolic diseases and frailty in older Chinese adults in the Beijing Longitudinal Study of Ageing. Age and ageing. 2013;42:346–351.CrossRefPubMed
21.
go back to reference Yu P, Song X, Shi J, et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Archives of gerontology and geriatrics. 2012;54:3–8.CrossRefPubMed Yu P, Song X, Shi J, et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Archives of gerontology and geriatrics. 2012;54:3–8.CrossRefPubMed
22.
go back to reference Shi J, Yang Z, Song X, et al. Sex differences in the limit to deficit accumulation in late middle-aged and older Chinese people: results from the Beijing Longitudinal Study of Aging. The journals of gerontology Series A, Biological sciences and medical sciences. 2014;69:702–709.CrossRefPubMedPubMedCentral Shi J, Yang Z, Song X, et al. Sex differences in the limit to deficit accumulation in late middle-aged and older Chinese people: results from the Beijing Longitudinal Study of Aging. The journals of gerontology Series A, Biological sciences and medical sciences. 2014;69:702–709.CrossRefPubMedPubMedCentral
23.
go back to reference Romero-Ortuno R. Frailty Index in Europeans: association with determinants of health. Geriatrics & gerontology international. 2014;14:420–429.CrossRef Romero-Ortuno R. Frailty Index in Europeans: association with determinants of health. Geriatrics & gerontology international. 2014;14:420–429.CrossRef
24.
go back to reference Bergmann MM, Byers T, Freedman DS & Mokdad A. Validity of self-reported diagnoses leading to hospitalization: a comparison of self-reports with hospital records in a prospective study of American adults. American journal of epidemiology. 1998;147:969–977.CrossRefPubMed Bergmann MM, Byers T, Freedman DS & Mokdad A. Validity of self-reported diagnoses leading to hospitalization: a comparison of self-reports with hospital records in a prospective study of American adults. American journal of epidemiology. 1998;147:969–977.CrossRefPubMed
Metadata
Title
Frailty index and its relation to falls and overnight hospitalizations in elderly Chinese people: A population-based study
Authors
Z. Liu
Q. Wang
T. Zhi
Y. Zhu
Y. Wang
Z. Wang
J. Shi
X. Xie
X. Chu
X. Wang
Xiaoyan Jiang
Publication date
01-05-2016
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 5/2016
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-015-0625-6

Other articles of this Issue 5/2016

The journal of nutrition, health & aging 5/2016 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.