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Published in: The journal of nutrition, health & aging 5/2019

01-05-2019

Association Between Hospitalization and Change of Frailty Status in the Gazel Cohort

Authors: B. Landré, P. Aegerter, M. Zins, M. Goldberg, J. Ankri, Marie Herr

Published in: The journal of nutrition, health & aging | Issue 5/2019

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Abstract

Objectives

To assess the relationship between changes of frailty status and intervening hospitalizations, using information of the GAZEL cohort, matched with the data of the French National Health Data System. Design: Observational cohort study.

Participants

Community-dwelling adults of the GAZEL cohort (n = 12145; aged between 58 and 73 years in 2012).

Measurements

Frailty was determined with the Strawbridge questionnaire in 2012, 2013 and 2014. Data regarding hospitalizations (notably their number, length of stay, emergency department use, and main diagnosis) were collected from the French National Health Data System. The relationship between intervening hospitalizations and changes of frailty status over time was assessed with multivariate Markov models.

Results

The prevalence of frailty was 14% in 2012 and 2013 and 17% in 2014. A total of 2715 changes in frailty status were observed from 2012 to 2014. At least one hospitalization was recorded for 1453 people (12%) between the 2012 and 2013 questionnaires, and 1472 (13%) between the 2013 and 2014 questionnaires. No association was found between intervening hospitalizations and changes of frailty status (aHR 1.14 [0.97–1.35] for robust to frail transition and aHR 0.89 [0.73–1.08] for frail to robust transition). However, repeated hospitalizations, hospitalizations after emergency department use, surgery and several diagnosis groups were significantly associated with transitions towards frailty or its recovery.

Conclusion

Hospitalizations encompass a wide range of clinical situations, some of them being associated with incident frailty. An early recognition of these situations could help to better prevent and manage frailty in the early old age.
Literature
1.
go back to reference Fried LP, Tangen CM, Walston J, et al. Frailty in Older Adults: Evidence for a Phenotype. Journals Gerontol Ser A Biol Sci Med Sci. 2001;56(3):M146–M157. doi:10.1093/gerona/56.3.M146CrossRef Fried LP, Tangen CM, Walston J, et al. Frailty in Older Adults: Evidence for a Phenotype. Journals Gerontol Ser A Biol Sci Med Sci. 2001;56(3):M146–M157. doi:10.1093/gerona/56.3.M146CrossRef
2.
go back to reference Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of Deficits as a Proxy Measure of Aging. Sci World J. 2001;1:323–336. doi:10.1100/tsw.2001.58CrossRef Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of Deficits as a Proxy Measure of Aging. Sci World J. 2001;1:323–336. doi:10.1100/tsw.2001.58CrossRef
3.
go back to reference Acosta–Benito M, Sevilla–Machuca I. Using prefrailty to detect early disability. J Fam Community Med. 2016;23(3):140. doi:10.4103/2230–8229.189106CrossRef Acosta–Benito M, Sevilla–Machuca I. Using prefrailty to detect early disability. J Fam Community Med. 2016;23(3):140. doi:10.4103/2230–8229.189106CrossRef
4.
go back to reference De La Rica–Escuín M, González–Vaca J, Varela–Pérez R, et al. Frailty and mortality or incident disability in institutionalized older adults: The FINAL Study. Maturitas. 2014;78(4):329–334. doi:10.1016/j.maturitas.2014.05.022CrossRefPubMed De La Rica–Escuín M, González–Vaca J, Varela–Pérez R, et al. Frailty and mortality or incident disability in institutionalized older adults: The FINAL Study. Maturitas. 2014;78(4):329–334. doi:10.1016/j.maturitas.2014.05.022CrossRefPubMed
5.
go back to reference Trevisan C, Veronese N, Maggi S, et al. Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc. 2017;65(1):179–184. doi:10.1111/jgs.14515CrossRefPubMed Trevisan C, Veronese N, Maggi S, et al. Factors Influencing Transitions Between Frailty States in Elderly Adults: The Progetto Veneto Anziani Longitudinal Study. J Am Geriatr Soc. 2017;65(1):179–184. doi:10.1111/jgs.14515CrossRefPubMed
6.
go back to reference Lee JSW, Auyeung T–W, Leung J, Kwok T, Woo J. Transitions in Frailty States Among Community–Living Older Adults and Their Associated Factors. J Am Med Dir Assoc. 2014;15(4):281–286. doi:10.1016/j.jamda.2013.12.002CrossRefPubMed Lee JSW, Auyeung T–W, Leung J, Kwok T, Woo J. Transitions in Frailty States Among Community–Living Older Adults and Their Associated Factors. J Am Med Dir Assoc. 2014;15(4):281–286. doi:10.1016/j.jamda.2013.12.002CrossRefPubMed
7.
go back to reference Gill TM, Gahbauer EA, Han L, Allore HG. The relationship between intervening hospitalizations and transitions between frailty states. Journals Gerontol–Ser A Biol Sci Med Sci. 2011;66 A(11):1238–1243. doi:10.1093/gerona/glr142CrossRef Gill TM, Gahbauer EA, Han L, Allore HG. The relationship between intervening hospitalizations and transitions between frailty states. Journals Gerontol–Ser A Biol Sci Med Sci. 2011;66 A(11):1238–1243. doi:10.1093/gerona/glr142CrossRef
8.
go back to reference Jamsen KM, Bell JS, Hilmer SN, et al. Effects of Changes in Number of Medications and Drug Burden Index Exposure on Transitions between Frailty States and Death: The Concord Health and Ageing in Men Project Cohort Study. J Am Geriatr Soc. 2016;64(1):89–95. doi:10.1111/jgs.13877CrossRefPubMed Jamsen KM, Bell JS, Hilmer SN, et al. Effects of Changes in Number of Medications and Drug Burden Index Exposure on Transitions between Frailty States and Death: The Concord Health and Ageing in Men Project Cohort Study. J Am Geriatr Soc. 2016;64(1):89–95. doi:10.1111/jgs.13877CrossRefPubMed
9.
go back to reference Feng Z, Lugtenberg M, Franse C, et al. Risk factors and protective factors associated with incident or increase of frailty among community–dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12(6):1–18. doi:10.1371/journal.pone.0178383 Feng Z, Lugtenberg M, Franse C, et al. Risk factors and protective factors associated with incident or increase of frailty among community–dwelling older adults: A systematic review of longitudinal studies. PLoS One. 2017;12(6):1–18. doi:10.1371/journal.pone.0178383
10.
go back to reference Muscedere J, Waters B, Varambally A, et al. The impact of frailty on intensive care unit outcomes: a systematic review and meta–analysis. Intensive Care Med. 2017;43(8):1105–1122. doi:10.1007/s00134–017–4867–0CrossRefPubMedPubMedCentral Muscedere J, Waters B, Varambally A, et al. The impact of frailty on intensive care unit outcomes: a systematic review and meta–analysis. Intensive Care Med. 2017;43(8):1105–1122. doi:10.1007/s00134–017–4867–0CrossRefPubMedPubMedCentral
11.
go back to reference Hogan DB, Maxwell CJ, Afilalo J, et al. A Scoping Review of Frailty and Acute Care in Middle–Aged and Older Individuals with Recommendations for Future Research. Can Geriatr J. 2017;20(1):22–37. doi:10.5770/cgj.20.240CrossRefPubMedPubMedCentral Hogan DB, Maxwell CJ, Afilalo J, et al. A Scoping Review of Frailty and Acute Care in Middle–Aged and Older Individuals with Recommendations for Future Research. Can Geriatr J. 2017;20(1):22–37. doi:10.5770/cgj.20.240CrossRefPubMedPubMedCentral
12.
go back to reference Covinsky KE, Pierluissi E, Story THEPS. CLINICIAN’ S CORNER Hospitalization–Associated Disability “ She Was Probably Able to Ambulate, but I’ m Not Sure ”–JAMA–2011.pdf. 2015. Covinsky KE, Pierluissi E, Story THEPS. CLINICIAN’ S CORNER Hospitalization–Associated Disability “ She Was Probably Able to Ambulate, but I’ m Not Sure ”–JAMA–2011.pdf. 2015.
13.
go back to reference Zisberg A, Shadmi E, Gur–Yaish N, Tonkikh O, Sinoff G. Hospital–Associated Functional Decline: The Role of Hospitalization Processes Beyond Individual Risk Factors. J Am Geriatr Soc. 2015;63(1):55–62. doi:10.1111/jgs.13193CrossRefPubMed Zisberg A, Shadmi E, Gur–Yaish N, Tonkikh O, Sinoff G. Hospital–Associated Functional Decline: The Role of Hospitalization Processes Beyond Individual Risk Factors. J Am Geriatr Soc. 2015;63(1):55–62. doi:10.1111/jgs.13193CrossRefPubMed
14.
go back to reference Kuys SS, Dolecka UE, Guard A. Activity level of hospital medical inpatients: An observational study. Arch Gerontol Geriatr. 2012;55(2):417–421. doi:10.1016/j. archger.2012.02.008CrossRefPubMed Kuys SS, Dolecka UE, Guard A. Activity level of hospital medical inpatients: An observational study. Arch Gerontol Geriatr. 2012;55(2):417–421. doi:10.1016/j. archger.2012.02.008CrossRefPubMed
15.
go back to reference Goldberg M, Leclerc A, Bonenfant S, et al. Cohort profile: The GAZEL Cohort Study. Int J Epidemiol. 2007;36(1):32–39. doi:10.1093/ije/dyl247CrossRefPubMed Goldberg M, Leclerc A, Bonenfant S, et al. Cohort profile: The GAZEL Cohort Study. Int J Epidemiol. 2007;36(1):32–39. doi:10.1093/ije/dyl247CrossRefPubMed
16.
go back to reference William J. Strawbridge, Sarah J. Shema, Jennifer L. Balfour, Helen R. Higby and GAK. Antecedents of Frailty Over Three Decades in an Older Cohort. 1998:9–16. William J. Strawbridge, Sarah J. Shema, Jennifer L. Balfour, Helen R. Higby and GAK. Antecedents of Frailty Over Three Decades in an Older Cohort. 1998:9–16.
17.
go back to reference Tuppin P, Rudant J, Constantinou P, et al. L’utilité d’une base médico–administrative nationale pour guider la décision publique: du système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) vers le système national des données de santé (SNDS) en France. Rev Epidemiol Sante Publique. 2017;65:S149–S167. doi:10.1016/j.respe.2017.05.004CrossRefPubMed Tuppin P, Rudant J, Constantinou P, et al. L’utilité d’une base médico–administrative nationale pour guider la décision publique: du système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) vers le système national des données de santé (SNDS) en France. Rev Epidemiol Sante Publique. 2017;65:S149–S167. doi:10.1016/j.respe.2017.05.004CrossRefPubMed
18.
go back to reference Delahaye–Guillocheau V. Manuel Des Groupes Homogènes de Malades. Ministère des Aff Soc la Santé. 2017;1(2017/5 bis):1–53. Delahaye–Guillocheau V. Manuel Des Groupes Homogènes de Malades. Ministère des Aff Soc la Santé. 2017;1(2017/5 bis):1–53.
19.
go back to reference IRDES. La polymédication: définitions, mesures et enjeux–Revue de la littérature et tests de mesure. Quest d’écomomie la santé. 2014;204:8. IRDES. La polymédication: définitions, mesures et enjeux–Revue de la littérature et tests de mesure. Quest d’écomomie la santé. 2014;204:8.
20.
go back to reference Alvarado BE, Zunzunegui M–V, Béland F, Bamvita J–M. Life course social and health conditions linked to frailty in Latin American older men and women. J Gerontol A Biol Sci Med Sci. 2008;63(12):1399–1406. http://www.ncbi.nlm.nih.gov/pubmed/19126855. Accessed January 12, 2018.CrossRefPubMed Alvarado BE, Zunzunegui M–V, Béland F, Bamvita J–M. Life course social and health conditions linked to frailty in Latin American older men and women. J Gerontol A Biol Sci Med Sci. 2008;63(12):1399–1406. http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​19126855.​ Accessed January 12, 2018.CrossRefPubMed
21.
go back to reference Jackson C. Multi–state modelling with R: the msm package. Cambridge, UK. 2007:1–53. ftp://218.193.60.3/software/rsoft/msm/doc/msm–manual.pdf. Jackson C. Multi–state modelling with R: the msm package. Cambridge, UK. 2007:1–53. ftp://218.193.60.3/software/rsoft/msm/doc/msm–manual.pdf.
22.
go back to reference Matthews M, Lucas A, Boland R, et al. Use of a questionnaire to screen for frailty in the elderly: an exploratory study. Aging Clin Exp Res. 2004;16(1):34–40. doi:10.1007/BF03324529CrossRefPubMed Matthews M, Lucas A, Boland R, et al. Use of a questionnaire to screen for frailty in the elderly: an exploratory study. Aging Clin Exp Res. 2004;16(1):34–40. doi:10.1007/BF03324529CrossRefPubMed
23.
go back to reference Hospitalière AT de l’information. Vieillissement de La Population et Évolution de l’activité Hospitalière 2007–2010: Focus Sur La Prise En Charge Des 80ans et Plus.; 2015. Hospitalière AT de l’information. Vieillissement de La Population et Évolution de l’activité Hospitalière 2007–2010: Focus Sur La Prise En Charge Des 80ans et Plus.; 2015.
24.
go back to reference Newman a B, Gottdiener JS, Mcburnie MA, et al. Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci. 2001;56(3):M158–66. doi:10.1093/gerona/56.3.M158CrossRefPubMed Newman a B, Gottdiener JS, Mcburnie MA, et al. Associations of subclinical cardiovascular disease with frailty. J Gerontol A Biol Sci Med Sci. 2001;56(3):M158–66. doi:10.1093/gerona/56.3.M158CrossRefPubMed
25.
go back to reference IInouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric Syndromes: Clinical Research, and Policy Implications of a Core Geriatric Concept. J Am Geriatr Soc. 2007;55(5):780–791. doi:10.1111/j.1532–5415.2007.01156.xCrossRef IInouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric Syndromes: Clinical Research, and Policy Implications of a Core Geriatric Concept. J Am Geriatr Soc. 2007;55(5):780–791. doi:10.1111/j.1532–5415.2007.01156.xCrossRef
26.
go back to reference Venturini CD, Engroff P, Ely LS, et al. Gender differences, polypharmacy, and potential pharmacological interactions in the elderly. Clinics (Sao Paulo). 2011;66(11):1867–1872. http://www.ncbi.nlm.nih.gov/pubmed/22086515. Accessed January 12, 2018.PubMedPubMedCentral Venturini CD, Engroff P, Ely LS, et al. Gender differences, polypharmacy, and potential pharmacological interactions in the elderly. Clinics (Sao Paulo). 2011;66(11):1867–1872. http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​22086515.​ Accessed January 12, 2018.PubMedPubMedCentral
27.
go back to reference Li N, Chen G, Zeng P, et al. Prevalence of depression and its associated factors among Chinese elderly people: A comparison study between community–based population and hospitalized population. Psychiatry Res. 2016;243:87–91. doi:10.1016/j. psychres.2016.05.030CrossRefPubMed Li N, Chen G, Zeng P, et al. Prevalence of depression and its associated factors among Chinese elderly people: A comparison study between community–based population and hospitalized population. Psychiatry Res. 2016;243:87–91. doi:10.1016/j. psychres.2016.05.030CrossRefPubMed
28.
go back to reference Gill TM. Disentangling the disabling process: Insights from the precipitating events project. Gerontologist. 2014;54(4):533–549. doi:10.1093/geront/gnu067CrossRefPubMedPubMedCentral Gill TM. Disentangling the disabling process: Insights from the precipitating events project. Gerontologist. 2014;54(4):533–549. doi:10.1093/geront/gnu067CrossRefPubMedPubMedCentral
29.
go back to reference Sharabiani MTA, Aylin P, Bottle A. Systematic Review of Comorbidity Indices for Administrative Data. Med Care. 2012;50(12):1109–1118. doi:10.1097/MLR.0b013e31825f64d0CrossRefPubMed Sharabiani MTA, Aylin P, Bottle A. Systematic Review of Comorbidity Indices for Administrative Data. Med Care. 2012;50(12):1109–1118. doi:10.1097/MLR.0b013e31825f64d0CrossRefPubMed
30.
go back to reference Røsstad T, Garåsen H, Steinsbekk A, Håland E, Kristoffersen L, Grimsmo A. Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care. BMC Health Serv Res. 2015;15(1):1–9. doi:10.1186/s12913–015–0751–1CrossRef Røsstad T, Garåsen H, Steinsbekk A, Håland E, Kristoffersen L, Grimsmo A. Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care. BMC Health Serv Res. 2015;15(1):1–9. doi:10.1186/s12913–015–0751–1CrossRef
31.
go back to reference Van Oostveen CJ, Ubbink DT, Huis In Het Veld JG, Bakker PJ, Vermeulen H. Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: A systematic review. PLoS One. 2014;9(5). doi:10.1371/journal. pone.0098102 Van Oostveen CJ, Ubbink DT, Huis In Het Veld JG, Bakker PJ, Vermeulen H. Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: A systematic review. PLoS One. 2014;9(5). doi:10.1371/journal. pone.0098102
32.
go back to reference Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a Predictor of Surgical Outcomes in Older Patients. J Am Coll Surg. 2010;210(6):901–908. doi:10.1016/j. jamcollsurg.2010.01.028CrossRefPubMed Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a Predictor of Surgical Outcomes in Older Patients. J Am Coll Surg. 2010;210(6):901–908. doi:10.1016/j. jamcollsurg.2010.01.028CrossRefPubMed
33.
go back to reference Sheshadri A, Johansen KL. Prehabilitation for the Frail Patient Approaching ESRD. Semin Nephrol. 2017;37(2):159–172. doi:10.1016/j.semnephrol.2016.12.006CrossRefPubMedPubMedCentral Sheshadri A, Johansen KL. Prehabilitation for the Frail Patient Approaching ESRD. Semin Nephrol. 2017;37(2):159–172. doi:10.1016/j.semnephrol.2016.12.006CrossRefPubMedPubMedCentral
34.
go back to reference Carli F, Awasthi R, Gillis C, Kassouf W. Optimizing a frail elderly patient for radical cystectomy with a prehabilitation program. J Can Urol Assoc. 2014;8(11–12):e884–e887. doi:10.5489/cuaj.2025CrossRef Carli F, Awasthi R, Gillis C, Kassouf W. Optimizing a frail elderly patient for radical cystectomy with a prehabilitation program. J Can Urol Assoc. 2014;8(11–12):e884–e887. doi:10.5489/cuaj.2025CrossRef
35.
go back to reference Gill TM, Baker DI, Gottschalk M, et al. A prehabilitation program for physically frail community–living older persons. Arch Phys Med Rehabil. 2003;84(3SUPPL. 1):394–404. doi:10.1053/apmr.2003.50020CrossRefPubMed Gill TM, Baker DI, Gottschalk M, et al. A prehabilitation program for physically frail community–living older persons. Arch Phys Med Rehabil. 2003;84(3SUPPL. 1):394–404. doi:10.1053/apmr.2003.50020CrossRefPubMed
Metadata
Title
Association Between Hospitalization and Change of Frailty Status in the Gazel Cohort
Authors
B. Landré
P. Aegerter
M. Zins
M. Goldberg
J. Ankri
Marie Herr
Publication date
01-05-2019
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 5/2019
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-019-1186-x

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