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The journal of nutrition, health & aging

Published in:

01-05-2017

Association between physical frailty and quality of life in a representative sample of community-dwelling Swiss older people

Authors: Yves Henchoz, C. Büla, I. Guessous, B. Santos-Eggimann

Published in: The journal of nutrition, health & aging | Issue 5/2017

Abstract

Objective

Though the association between physical frailty and health is well established, little is known about its association with other domains of quality of life (QoL). This study investigated the association between physical frailty and multiple domains of QoL in community-dwelling older people.

Design

Cross-sectional study.

Setting and participants

Data of the 2011 annual assessment of 927 older people (age 73-77 years) from the Lc65+ cohort study were used.

Measurements

Physical frailty was assessed by Fried’s five criteria: ‘shrinking’; ‘weakness’; ‘poor endurance, exhaustion’; ‘slowness’; and ‘low activity’. QoL was assessed using 28 items yielding a QoL score and seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; and Social and cultural life). Low QoL (QoL score or QoL subscores in the lowest quintile) was used as dependent variable in logistic regression analyses adjusted for age and sex (model 1), and additionally for socioeconomic (model 2) and health (model 3) covariates.

Results

Physical frailty was associated with a low QoL score, as well as decreased QoL subscores in all seven specific domains, even after adjusting for socio-economic covariates. However, when performing additional adjustment for health covariates, only the domain Health and mobility remained significantly associated with physical frailty. Among each specific Fried’s criteria, ‘slowness’ had the strongest association with a low QoL score.

Conclusion

Physical frailty is associated with all QoL domains, but these associations are largely explained by poor health characteristics. Longitudinal studies are needed to better understand temporal relationships between physical frailty, health and QoL.

Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3): M146–156.CrossRefPubMed

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381(9868): 752–762. doi: 10.1016/S0140-6736(12)62167-9CrossRefPubMed

Bandeen-Roche K, Xue QL, Ferrucci L, et al. Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 2006;61(3): 262–266.CrossRefPubMed

Abizanda P, Romero L, Sanchez-Jurado PM, Martinez-Reig M, Gomez-Arnedo L, Alfonso SA. Frailty and mortality, disability and mobility loss in a Spanish cohort of older adults: the FRADEA study. Maturitas 2013;74(1): 54–60. doi: 10.1016/j. maturitas.2012.09.018CrossRefPubMed

Makizako H, Shimada H, Doi T, Tsutsumimoto K, Suzuki T. Impact of physical frailty on disability in community-dwelling older adults: a prospective cohort study. BMJ Open 2015;5(9): e008462. doi: 10.1136/bmjopen-2015-008462CrossRefPubMedPubMedCentral

Rockwood K, Howlett SE, MacKnight C, et al. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 2004;59(12): 1310–1317.CrossRefPubMed

Ensrud KE, Ewing SK, Taylor BC, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Arch Intern Med 2008;168(4): 382–389. doi: 10.1001/archinternmed.2007.113CrossRefPubMed

Gill TM, Gahbauer EA, Han L, Allore HG. Trajectories of disability in the last year of life. N Engl J Med 2010;362(13): 1173–1180. doi: 10.1056/NEJMoa0909087CrossRefPubMedPubMedCentral

Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med 2011;27(1): 17–26. doi: 10.1016/j. cger.2010.08.008CrossRefPubMed

10.

WHO. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995;41(10): 1403–1409.CrossRef

11.

Masel MC, Graham JE, Reistetter TA, Markides KS, Ottenbacher KJ. Frailty and health related quality of life in older Mexican Americans. Health Qual Life Outcomes 2009;7:70. doi: 10.1186/1477-7525-7-70CrossRefPubMedPubMedCentral

12.

Lin CC, Li CI, Chang CK, et al. Reduced health-related quality of life in elders with frailty: a cross-sectional study of community-dwelling elders in Taiwan. PLoS One 2011;6(7): e21841. doi: 10.1371/journal.pone.0021841CrossRefPubMedPubMedCentral

13.

Jurschik P, Nunin C, Botigue T, Escobar MA, Lavedan A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Arch Gerontol Geriatr 2012;55(3): 625–631. doi: 10.1016/j. archger.2012.07.002CrossRefPubMed

14.

Moreno-Aguilar M, García-Lara JMA, Aguilar-Navarro S, Navarrete-Reyes AP, Amieva H, Avila-Funes JA. The phenotype of frailty and health-related quality of life. J Frailty Aging 2013;2(1): 2–7.PubMed

15.

Mulasso A, Roppolo M, Rabaglietti E. The role of individual characteristics and physical frailty on health related quality of life (HRQOL): a cross sectional study of Italian community-dwelling older adults. Arch Gerontol Geriatr 2014;59(3): 542–548. doi: 10.1016/j.archger.2014.08.012CrossRefPubMed

16.

Op Het Veld LP, van Rossum E, Kempen GI, de Vet HC, Hajema K, Beurskens AJ. Fried phenotype of frailty: cross-sectional comparison of three frailty stages on various health domains. BMC Geriatr 2015;15:77. doi: 10.1186/s12877-015-0078-0CrossRefPubMedPubMedCentral

17.

De Vriendt P, Peersman W, Florus A, Verbeke M, Van de Velde D. Improving Health Related Quality of Life and Independence in Community Dwelling Frail Older Adults through a Client-Centred and Activity-Oriented Program. A Pragmatic Randomized Controlled Trial. J Nutr Health Aging 2016;20(1): 35–40. doi: 10.1007/s12603-015-0581-1CrossRefPubMed

18.

Bilotta C, Bowling A, Case A, et al. Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Outcomes 2010;8:56. doi: 10.1186/1477-7525-8-56CrossRefPubMedPubMedCentral

19.

Gobbens RJ, van Assen MA, Luijkx KG, Schols JM. Testing an integral conceptual model of frailty. J Adv Nurs 2012;68(9): 2047–2060. doi: 10.1111/j.1365-2648.2011.05896.xCrossRefPubMed

20.

Gobbens RJ, Luijkx KG, van Assen MA. Explaining quality of life of older people in the Netherlands using a multidimensional assessment of frailty. Qual Life Res 2013;22(8): 2051–2061. doi: 10.1007/s11136-012-0341-1CrossRefPubMed

21.

Gobbens RJ, van Assen MA. The prediction of quality of life by physical, psychological and social components of frailty in community-dwelling older people. Qual Life Res 2014;23(8): 2289–2300. doi: 10.1007/s11136-014-0672-1CrossRefPubMed

22.

Hubbard RE, Goodwin VA, Llewellyn DJ, Warmoth K, Lang IA. Frailty, financial resources and subjective well-being in later life. Arch Gerontol Geriatr 2014;58(3): 364–369. doi: 10.1016/j.archger.2013.12.008CrossRefPubMed

23.

Wu TY, Chie WC, Kuo KL, et al. Quality of life (QOL) among community dwelling older people in Taiwan measured by the CASP-19, an index to capture QOL in old age. Arch Gerontol Geriatr 2013;57(2): 143–150. doi: 10.1016/j.archger.2013.03.010CrossRefPubMed

24.

Santos-Eggimann B, Karmaniola A, Seematter-Bagnoud L, et al. The Lausanne cohort Lc65+: a population-based prospective study of the manifestations, determinants and outcomes of frailty. BMC Geriatr 2008;8:20. doi: 10.1186/1471-2318-8-20CrossRefPubMedPubMedCentral

25.

Henchoz Y, Meylan L, Goy R, et al. Domains of importance to the quality of life of older people from two Swiss regions. Age Ageing 2015;44(6): 979–985. doi: 10.1093/ageing/afv130CrossRefPubMed

26.

Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist 1970;10(1): 20–30.CrossRefPubMed

27.

Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med 1997;12(7): 439–445.CrossRefPubMedPubMedCentral

28.

Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3): 189–198.CrossRefPubMed

29.

White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Stat Med 2011;30(4): 377–399. doi: 10.1002/sim.4067CrossRefPubMed

30.

Li KH, Meng XL, Raghunathan TE, Rubin DB. Significance levels from repeated p-values with multiply-imputed data. Stat Sin 1991;1(1): 65–92.

31.

Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59(3): 255–263.CrossRefPubMed

32.

Chang YW, Chen WL, Lin FG, et al. Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users. PLoS One 2012;7(5): e38079. doi: 10.1371/journal.pone.0038079CrossRefPubMedPubMedCentral

33.

Peel NM, Kuys SS, Klein K. Gait speed as a measure in geriatric assessment in clinical settings: a systematic review. J Gerontol A Biol Sci Med Sci 2013;68(1): 39–46. doi: 10.1093/gerona/gls174CrossRefPubMed

34.

Castell MV, Sanchez M, Julian R, Queipo R, Martin S, Otero A. Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care. BMC Fam Pract 2013;14:86. doi: 10.1186/1471-2296-14-86CrossRefPubMedPubMedCentral

35.

Calvani R, Marini F, Cesari M, et al. Biomarkers for physical frailty and sarcopenia: state of the science and future developments. J Cachexia Sarcopenia Muscle 2015;6(4): 278–286. doi: 10.1002/jcsm.12051CrossRefPubMedPubMedCentral

36.

Cesari M, Landi F, Vellas B, Bernabei R, Marzetti E. Sarcopenia and physical frailty: two sides of the same coin. Front Aging Neurosci 2014;6:192. doi: 10.3389/fnagi.2014.00192PubMedPubMedCentral

37.

Keevil VL, Romero-Ortuno R. Ageing well: a review of sarcopenia and frailty. Proc Nutr Soc 2015;74(4): 337–347. doi: 10.1017/S0029665115002037CrossRefPubMed

38.

Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012;60(8): 1487–1492. doi: 10.1111/j.1532-5415.2012.04054.xCrossRefPubMed

39.

Santos-Eggimann B, Cuenoud P, Spagnoli J, Junod J. Prevalence of frailty in middleaged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci 2009;64(6): 675–681. doi: 10.1093/gerona/glp012CrossRefPubMed

40.

Peters LL, Boter H, Buskens E, Slaets JP. Measurement properties of the Groningen Frailty Indicator in home-dwelling and institutionalized elderly people. J Am Med Dir Assoc 2012;13(6): 546–551. doi: 10.1016/j.jamda.2012.04.007CrossRefPubMed

41.

Fitten LJ. Thinking about cognitive frailty. J Prev Alzheimers Dis 2015;2(1): 7–10.

Title: Association between physical frailty and quality of life in a representative sample of community-dwelling Swiss older people
Authors: Yves Henchoz
C. Büla
I. Guessous
B. Santos-Eggimann
Publication date: 01-05-2017
Publisher: Springer Paris
Published in: The journal of nutrition, health & aging / Issue 5/2017
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-016-0772-4

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Association between physical frailty and quality of life in a representative sample of community-dwelling Swiss older people

Abstract

Objective

Design

Setting and participants

Measurements

Results

Conclusion

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Results

Conclusion

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