Skip to main content
Top
Published in: European Journal of Ageing 4/2005

01-12-2005 | Original Investigation

The effect of frailty on residential/nursing home admission in the Netherlands independent of chronic diseases and functional limitations

Authors: Martine T. E. Puts, Paul Lips, Miel W. Ribbe, Dorly J. H. Deeg

Published in: European Journal of Ageing | Issue 4/2005

Login to get access

Abstract

The aim of this study was to determine the effect of frailty on the risk of residential/nursing home admission independently of chronic diseases and functional limitations. Frailty consists of multisystem decline and is considered to be a consequence of changes in neuromuscular, endocrine and immune system functioning that occur as people age. Frailty is a combination of multiple impairments in functioning that might lead to functional limitations and disability but it is not clear whether frailty has an independent effect on residential/nursing home admission. Data were used from the Longitudinal Aging Study Amsterdam. The respondents participated at both T 1 (1992/1993) and T 2 (1995/1996), lived independently at T 2, and were aged 65 and over (n=1,503). Nine frailty markers were assessed at two cycles (T 1 and T 2). The frailty markers were defined in two ways: low functioning at T 2 (static frailty); and change in functioning between T 1 and T 2 (dynamic frailty). The outcome variable was residential/nursing home admission between T 2 and T 4 (2001/2002). Cox proportional hazard analyses were used adjusting for chronic diseases, functional limitations, care received, partner status, income, age and sex. Static (RR 1.93, 95%CI 1.36–2.74) and dynamic frailty (RR 1.69, 95%CI 1.19–2.39) were associated with institutionalization in both men and women independently of the effect of chronic diseases and functional limitations. Additional analyses of the total number of both sets of frailty markers present revealed an increased risk of institutionalization when the number increased. In conclusion, frailty is associated with institutionalization, independently of the effect of chronic diseases and functional limitations.
Literature
go back to reference Bharucha AJ, Pandav R, Shen C, Dodge HH, Ganguli M (2004) Predictors of nursing facility admission: a 12-year epidemiological study in the United States. J Am Geriatr Soc 52:434–439CrossRef Bharucha AJ, Pandav R, Shen C, Dodge HH, Ganguli M (2004) Predictors of nursing facility admission: a 12-year epidemiological study in the United States. J Am Geriatr Soc 52:434–439CrossRef
go back to reference Bortz WM (2002) A conceptual framework of frailty: a review. J Gerontol A Biol Sci Med Sci 57:M283–M288 Bortz WM (2002) A conceptual framework of frailty: a review. J Gerontol A Biol Sci Med Sci 57:M283–M288
go back to reference Brown I, Renwick R, Raphael D (1995) Frailty: constructing a common meaning, definition, and conceptual framework. Int J Rehabil Res 18:93–102CrossRef Brown I, Renwick R, Raphael D (1995) Frailty: constructing a common meaning, definition, and conceptual framework. Int J Rehabil Res 18:93–102CrossRef
go back to reference Buchner DM, Wagner EH (1992) Preventing frail health. Clin Geriatr Med 8:1–17 Buchner DM, Wagner EH (1992) Preventing frail health. Clin Geriatr Med 8:1–17
go back to reference Campbell AJ, Buchner DM (1997) Unstable disability and the fluctuations of frailty. Age Ageing 26:315–318CrossRef Campbell AJ, Buchner DM (1997) Unstable disability and the fluctuations of frailty. Age Ageing 26:315–318CrossRef
go back to reference van Campen C, van Gameren E (2003) Asking for help. Demand model nursing care (In Dutch: Vragen om hulp. Vraagmodel verpleging en verzorging) The Hague: Social and Cultural Plannning Office of the Netherlands van Campen C, van Gameren E (2003) Asking for help. Demand model nursing care (In Dutch: Vragen om hulp. Vraagmodel verpleging en verzorging) The Hague: Social and Cultural Plannning Office of the Netherlands
go back to reference Central Bureau of Statistics (1989) Health interview questionnaire heerlen: Central Bureau of Statistics Central Bureau of Statistics (1989) Health interview questionnaire heerlen: Central Bureau of Statistics
go back to reference Chin A Paw MJ, Dekker JM, Feskens EJ, Schouten EG, Kromhout D (1999) How to select a frail elderly population? A comparison of three working definitions. J Clin Epidemiol 52:1015–1021CrossRef Chin A Paw MJ, Dekker JM, Feskens EJ, Schouten EG, Kromhout D (1999) How to select a frail elderly population? A comparison of three working definitions. J Clin Epidemiol 52:1015–1021CrossRef
go back to reference Chin A Paw MJ, de Groot LC, van Gend SV, Schoterman MH, Schouten EG, Schroll M et al (2003) Inactivity and weight loss: effective criteria to identify frailty. J Nutr Health Aging 7:55–60 Chin A Paw MJ, de Groot LC, van Gend SV, Schoterman MH, Schouten EG, Schroll M et al (2003) Inactivity and weight loss: effective criteria to identify frailty. J Nutr Health Aging 7:55–60
go back to reference Cook NR, Albert MS, Berkman LF, Blazer D, Taylor JO, Hennekens CH (1995) Interrelationships of peak expiratory flow rate with physical and cognitive function in the elderly: MacArthur Foundation studies of aging. J Gerontol A Biol Sci Med Sci 50:M317–M323 Cook NR, Albert MS, Berkman LF, Blazer D, Taylor JO, Hennekens CH (1995) Interrelationships of peak expiratory flow rate with physical and cognitive function in the elderly: MacArthur Foundation studies of aging. J Gerontol A Biol Sci Med Sci 50:M317–M323
go back to reference Deeg DJH, Knipscheer CPM, van Tilburg W (1993) Autonomy and well-being in the aging population: concepts and design of the Longitudinal Aging Study Amsterdam. NIG-trend-studies No.7. Netherlands Institute of Gerontology, Bunnik Deeg DJH, Knipscheer CPM, van Tilburg W (1993) Autonomy and well-being in the aging population: concepts and design of the Longitudinal Aging Study Amsterdam. NIG-trend-studies No.7. Netherlands Institute of Gerontology, Bunnik
go back to reference Deeg DJ, van Tilburg T, Smit JH, de Leeuw ED (2002) Attrition in the Longitudinal Aging Study Amsterdam. The effect of differential inclusion in side studies. J Clin Epidemiol 55:319–328CrossRef Deeg DJ, van Tilburg T, Smit JH, de Leeuw ED (2002) Attrition in the Longitudinal Aging Study Amsterdam. The effect of differential inclusion in side studies. J Clin Epidemiol 55:319–328CrossRef
go back to reference Ferrucci L, Cavazzini C, Corsi A, Bartali B, Russo CR, Lauretani F et al (2002) Biomarkers of frailty in older persons. J Endocrinol Invest 25:10–15 Ferrucci L, Cavazzini C, Corsi A, Bartali B, Russo CR, Lauretani F et al (2002) Biomarkers of frailty in older persons. J Endocrinol Invest 25:10–15
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 12:189–198CrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 12:189–198CrossRef
go back to reference Fried LP, Walston J (1998) Frailty and failure to thrive. In: Hazzard WR, Blass J, Ettinger WH, Halter J, Ouslander J (eds) Principles of Geriatric Medicine and Gerontology, 4th edn. McGraw Hill, New York, pp 1387–1402 Fried LP, Walston J (1998) Frailty and failure to thrive. In: Hazzard WR, Blass J, Ettinger WH, Halter J, Ouslander J (eds) Principles of Geriatric Medicine and Gerontology, 4th edn. McGraw Hill, New York, pp 1387–1402
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001a) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156 Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001a) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156
go back to reference Fried LP, Young Y, Rubin G, Bandeen-Roche K (2001b) Self-reported preclinical disability identifies older women with early declines in performance and early disease. J Clin Epidemiol 54:889–901CrossRef Fried LP, Young Y, Rubin G, Bandeen-Roche K (2001b) Self-reported preclinical disability identifies older women with early declines in performance and early disease. J Clin Epidemiol 54:889–901CrossRef
go back to reference Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G (2004) Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 59:255–263 Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G (2004) Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 59:255–263
go back to reference Gaugler JE, Zarit SH, Pearlin LI (1999) Caregiving and institutionalization: perceptions of family conflict and socioemotional support. Int J Aging Hum Dev 49:1–25CrossRef Gaugler JE, Zarit SH, Pearlin LI (1999) Caregiving and institutionalization: perceptions of family conflict and socioemotional support. Int J Aging Hum Dev 49:1–25CrossRef
go back to reference Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A (2002) A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 347:1068–1074CrossRef Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A (2002) A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med 347:1068–1074CrossRef
go back to reference Hoek JF, Penninx BW, Ligthart GJ, Ribbe MW (2000) Health care for older persons, a country profile: The Netherlands. J Am Geriatr Soc 48:214–217 Hoek JF, Penninx BW, Ligthart GJ, Ribbe MW (2000) Health care for older persons, a country profile: The Netherlands. J Am Geriatr Soc 48:214–217
go back to reference Hogan DB, MacKnight C, Bergman H (2003) Models, definitions, and criteria of frailty. Aging Clin Exp Res 15:1–29 Hogan DB, MacKnight C, Bergman H (2003) Models, definitions, and criteria of frailty. Aging Clin Exp Res 15:1–29
go back to reference Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. J Clin Epidemiol 49:1407–1417CrossRef Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ (1996) Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. J Clin Epidemiol 49:1407–1417CrossRef
go back to reference Markle-Reid M, Browne G (2003) Conceptualizations of frailty in relation to older adults. J Adv Nurs 44:58–68CrossRef Markle-Reid M, Browne G (2003) Conceptualizations of frailty in relation to older adults. J Adv Nurs 44:58–68CrossRef
go back to reference Miles TP, Palmer RF, Espino DV, Mouton CP, Lichtenstein MJ, Markides KS (2001) New-onset incontinence and markers of frailty: data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. J Gerontol A Biol Sci Med Sci 56:M19–M24 Miles TP, Palmer RF, Espino DV, Mouton CP, Lichtenstein MJ, Markides KS (2001) New-onset incontinence and markers of frailty: data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly. J Gerontol A Biol Sci Med Sci 56:M19–M24
go back to reference Miller ME, Longino CF Jr, Anderson RT, James MK, Worley AS (1999) Functional status, assistance, and the risk of a community-based move. Gerontologist 39:187–200CrossRef Miller ME, Longino CF Jr, Anderson RT, James MK, Worley AS (1999) Functional status, assistance, and the risk of a community-based move. Gerontologist 39:187–200CrossRef
go back to reference Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K (2002a) Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr 2:1CrossRef Mitnitski AB, Graham JE, Mogilner AJ, Rockwood K (2002a) Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr 2:1CrossRef
go back to reference Mitnitski AB, Mogilner AJ, MacKnight C, Rockwood K (2002b) The mortality rate as a function of accumulated deficits in a frailty index. Mech Ageing Dev 123:1457–1460CrossRef Mitnitski AB, Mogilner AJ, MacKnight C, Rockwood K (2002b) The mortality rate as a function of accumulated deficits in a frailty index. Mech Ageing Dev 123:1457–1460CrossRef
go back to reference Morley JE, Perry HM III, Miller DK (2002) Editorial: something about frailty. J Gerontol A Biol Sci Med Sci 57:M698–M704 Morley JE, Perry HM III, Miller DK (2002) Editorial: something about frailty. J Gerontol A Biol Sci Med Sci 57:M698–M704
go back to reference Nuotio M, Tammela TL, LuukkaalaT, Jylha M (2003) Predictors of institutionalization in an older population during a 13-year period: the effect of urge incontinence. J Gerontol A Biol Sci Med Sci 58:756–762 Nuotio M, Tammela TL, LuukkaalaT, Jylha M (2003) Predictors of institutionalization in an older population during a 13-year period: the effect of urge incontinence. J Gerontol A Biol Sci Med Sci 58:756–762
go back to reference Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19:2–21CrossRef Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19:2–21CrossRef
go back to reference Puts MTE, Deeg DJH, Lips P (2005) Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc 53:40–47CrossRef Puts MTE, Deeg DJH, Lips P (2005) Sex differences in the risk of frailty for mortality independent of disability and chronic diseases. J Am Geriatr Soc 53:40–47CrossRef
go back to reference Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRef Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRef
go back to reference Raphael D, Cava M, Brown I, Renwick R, Heathcote K, Weir N et al (1995) Frailty: a public health perspective. Can J Public Health 86:224–227 Raphael D, Cava M, Brown I, Renwick R, Heathcote K, Weir N et al (1995) Frailty: a public health perspective. Can J Public Health 86:224–227
go back to reference Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB (1999) A brief clinical instrument to classify frailty in elderly people. Lancet 353:205–206CrossRef Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB (1999) A brief clinical instrument to classify frailty in elderly people. Lancet 353:205–206CrossRef
go back to reference Rockwood K, Hogan DB, MacKnight C (2000) Conceptualization and measurement of frailty in elderly people. Drugs Aging 17:295–302CrossRef Rockwood K, Hogan DB, MacKnight C (2000) Conceptualization and measurement of frailty in elderly people. Drugs Aging 17:295–302CrossRef
go back to reference Schiepers JMP (1988) Family equivalence scales using the budget distribution method (In Dutch Huishoudsequivalenten volgens de budgetverdelings-methode) Supplement Sociaal-economische Maandstatistiek, pp 28–36 Schiepers JMP (1988) Family equivalence scales using the budget distribution method (In Dutch Huishoudsequivalenten volgens de budgetverdelings-methode) Supplement Sociaal-economische Maandstatistiek, pp 28–36
go back to reference Scott WK, Edwards KB, Davis DR, Cornman CB, Macera CA (1997) Risk of institutionalization among community long-term care clients with dementia. Gerontologist 37:46–51 Scott WK, Edwards KB, Davis DR, Cornman CB, Macera CA (1997) Risk of institutionalization among community long-term care clients with dementia. Gerontologist 37:46–51
go back to reference Smit JH, De Vries MZ, Poppelaars JL (1998) Data collection and fieldwork procedures. In: Deeg DJH, Beekman ATF, Kriegsman DMW, Westendorp- de Serière M (eds) Autonomy and well-being in the Aging Population II. Report from the Longitudinal Aging Study Amsterdam 1992–1996. VU University Press, Amsterdam, pp 9–20 Smit JH, De Vries MZ, Poppelaars JL (1998) Data collection and fieldwork procedures. In: Deeg DJH, Beekman ATF, Kriegsman DMW, Westendorp- de Serière M (eds) Autonomy and well-being in the Aging Population II. Report from the Longitudinal Aging Study Amsterdam 1992–1996. VU University Press, Amsterdam, pp 9–20
go back to reference van Sonsbeek JLA (1988) Methodological and substantial aspects of the OECD indicator of chronic functional limitations. (In Dutch) Maandbericht Gezondheid (CBS) 88:4–17 van Sonsbeek JLA (1988) Methodological and substantial aspects of the OECD indicator of chronic functional limitations. (In Dutch) Maandbericht Gezondheid (CBS) 88:4–17
go back to reference Speer DC, Greenbaum PE (1995) Five methods for computing significant individual client change and improvement rates: support for an individual growth curve approach. J Consult Clin Psychol 63:1044–1048CrossRef Speer DC, Greenbaum PE (1995) Five methods for computing significant individual client change and improvement rates: support for an individual growth curve approach. J Consult Clin Psychol 63:1044–1048CrossRef
go back to reference Stel VS, Smit JH, Pluijm SM, Visser M, Deeg DJ, Lips P (2004) Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. J Clin Epidemiol 57:252–258CrossRef Stel VS, Smit JH, Pluijm SM, Visser M, Deeg DJ, Lips P (2004) Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. J Clin Epidemiol 57:252–258CrossRef
go back to reference Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA (1998) Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci 53:S9–S16 Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA (1998) Antecedents of frailty over three decades in an older cohort. J Gerontol B Psychol Sci Soc Sci 53:S9–S16
go back to reference Tomiak M, Berthelot JM, Guimond E, Mustard CA (2000) Factors associated with nursing-home entry for elders in Manitoba, Canada. J Gerontol A Biol Sci Med Sci 55:M279–M287 Tomiak M, Berthelot JM, Guimond E, Mustard CA (2000) Factors associated with nursing-home entry for elders in Manitoba, Canada. J Gerontol A Biol Sci Med Sci 55:M279–M287
go back to reference Verbrugge LM (2005) Flies without wings. In: Carey R, Robine J-M, Michel J-P, Christen Y (eds) Longevity and frailty. Springer, Berlin Heidelberg New York, pp 67–81CrossRef Verbrugge LM (2005) Flies without wings. In: Carey R, Robine J-M, Michel J-P, Christen Y (eds) Longevity and frailty. Springer, Berlin Heidelberg New York, pp 67–81CrossRef
go back to reference Verbrugge LM, Jette AM (1994) The disablement process. Soc Sci Med 38:1–14CrossRef Verbrugge LM, Jette AM (1994) The disablement process. Soc Sci Med 38:1–14CrossRef
go back to reference Walston J, Fried LP (1999) Frailty and the older man. Med Clin North Am 83:1173–1194CrossRef Walston J, Fried LP (1999) Frailty and the older man. Med Clin North Am 83:1173–1194CrossRef
go back to reference Wang JJ, Mitchell P, SmithW, Cumming RG, Leeder SR (2001) Incidence of nursing home placement in a defined community. Med J Aust 174:271–275 Wang JJ, Mitchell P, SmithW, Cumming RG, Leeder SR (2001) Incidence of nursing home placement in a defined community. Med J Aust 174:271–275
go back to reference Wilson JF (2004) Frailty—and its dangerous effects—might be preventable. Ann Intern Med 141:489–492 Wilson JF (2004) Frailty—and its dangerous effects—might be preventable. Ann Intern Med 141:489–492
go back to reference Winograd CH, Gerety MB, ChungM, Goldstein MK, Dominguez F Jr, Vallone R (1991) Screening for frailty: criteria and predictors of outcomes. J Am Geriatr Soc 39:778–784 Winograd CH, Gerety MB, ChungM, Goldstein MK, Dominguez F Jr, Vallone R (1991) Screening for frailty: criteria and predictors of outcomes. J Am Geriatr Soc 39:778–784
go back to reference Wolinsky FD, CallahanCM, Fitzgerald JF, Johnson RJ (1993) Changes in functional status and the risks of subsequent nursing home placement and death. J Gerontol 48:S94–S101 Wolinsky FD, CallahanCM, Fitzgerald JF, Johnson RJ (1993) Changes in functional status and the risks of subsequent nursing home placement and death. J Gerontol 48:S94–S101
go back to reference Wolinsky FD, MillerDK, Andresen EM, Malmstrom TK, Miller JP (2005) Further evidence for the importance of subclinical functional limitation and subclinical disability assessment in gerontology and geriatrics. J Gerontol B Psychol Sci Soc Sci 60:S146–S151 Wolinsky FD, MillerDK, Andresen EM, Malmstrom TK, Miller JP (2005) Further evidence for the importance of subclinical functional limitation and subclinical disability assessment in gerontology and geriatrics. J Gerontol B Psychol Sci Soc Sci 60:S146–S151
Metadata
Title
The effect of frailty on residential/nursing home admission in the Netherlands independent of chronic diseases and functional limitations
Authors
Martine T. E. Puts
Paul Lips
Miel W. Ribbe
Dorly J. H. Deeg
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
European Journal of Ageing / Issue 4/2005
Print ISSN: 1613-9372
Electronic ISSN: 1613-9380
DOI
https://doi.org/10.1007/s10433-005-0011-z

Other articles of this Issue 4/2005

European Journal of Ageing 4/2005 Go to the issue

Acknowledgement to Reviewers

Acknowledgement