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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Care | Research article

The Frailty In Residential Sector over Time (FIRST) study: methods and baseline cohort description

Authors: Agathe Daria Jadczak, Leonie Robson, Tina Cooper, J. Simon Bell, Renuka Visvanathan, on behalf of the FIRST Study Collaborators

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

The Frailty In Residential Sector over Time (FIRST) Study is a 3-year prospective cohort study investigating the health of residents living in residential aged care services (RACS) in South Australia. The study aims to examine the change in frailty status and associated health outcomes.

Methods

This interim report presents data from March 2019–October 2020. The study setting is 12 RACS from one organisation across metropolitan and rural South Australia involving 1243 residents. All permanent (i.e. respite or transition care program excluded) residents living in the RACS for at least 8 weeks were invited to participate. Residents who were deemed to be medically unstable (e.g. experiencing delirium), have less than 3 months to live, or not fluent in English were excluded. Data collected included frailty status, medical diagnoses, medicines, pain, nutrition, sarcopenia, falls, dementia, anxiety and depression, sleep quality, quality of life, satisfaction with care, activities of daily living, and life space use at baseline and 12-months. Data Linkage will occur over the 3 years from baseline.

Results

A total of 561 permanent residents (mean age 87.69 ± 7.25) were included. The majority of residents were female (n = 411, 73.3%) with 95.3% (n = 527) being classified as either frail (n = 377, 68.2%) or most-frail (n = 150, 27.1%) according to the Frailty Index (FI). Most residents were severely impaired in their basic activities of daily living (n = 554, 98.8%), and were at-risk of malnutrition (n = 305, 55.0%) and at-risk of sarcopenia (n = 492, 89.5%). Most residents did not experience pain (n = 475, 85.4%), had normal daytime sleepiness (n = 385, 69.7%), and low anxiety and depression scores (n = 327, 58.9%).

Conclusion

This study provides valuable information on the health and frailty levels of residents living in RACS in South Australia. The results will assist in developing interventions that can help to improve the health and wellbeing of residents in aged care services.

Trial registration

Prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000500​156).
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Literature
2.
go back to reference Simpson KN, Seamon BA, Hand BN, Roldan CO, Taber DJ, Moran WP, et al. Effect of frailty on resource use and cost for Medicare patients. J Comp Eff Res. 2018;7(8):817–25.PubMedPubMedCentralCrossRef Simpson KN, Seamon BA, Hand BN, Roldan CO, Taber DJ, Moran WP, et al. Effect of frailty on resource use and cost for Medicare patients. J Comp Eff Res. 2018;7(8):817–25.PubMedPubMedCentralCrossRef
3.
go back to reference Theou O, Sluggett JK, Bell JS, Lalic S, Cooper T, Robson L, et al. Frailty, hospitalization, and mortality in residential aged care. J Gerontol A Biol Sci Med Sci. 2018;73(8):1090–6.PubMedCrossRef Theou O, Sluggett JK, Bell JS, Lalic S, Cooper T, Robson L, et al. Frailty, hospitalization, and mortality in residential aged care. J Gerontol A Biol Sci Med Sci. 2018;73(8):1090–6.PubMedCrossRef
4.
go back to reference Taylor D, Barrie H, Lange J, et al. Geospatial modelling of the prevalence and changing distribution of frailty in Australia - 2011 to 2027. Exp Gerontol. 2019;123:57–65.PubMedCrossRef Taylor D, Barrie H, Lange J, et al. Geospatial modelling of the prevalence and changing distribution of frailty in Australia - 2011 to 2027. Exp Gerontol. 2019;123:57–65.PubMedCrossRef
6.
go back to reference Inacio MC, Lang CE, Bray SCE, Visvanathan R, Whitehead C, Griffith EC, et al. Health status and health care trends of individuals accessing Australian aged care programs over a decade: the registry of senior Australians (ROSA) historical cohort. Intern Med J. 2020. https://doi.org/10.1111/imj.14871. Inacio MC, Lang CE, Bray SCE, Visvanathan R, Whitehead C, Griffith EC, et al. Health status and health care trends of individuals accessing Australian aged care programs over a decade: the registry of senior Australians (ROSA) historical cohort. Intern Med J. 2020. https://​doi.​org/​10.​1111/​imj.​14871.
7.
go back to reference Theou O, Tan EC, Bell JS, Emery T, Robson L, Morley JE, et al. Frailty levels in residential aged care facilities measured using the frailty index and FRAIL-NH scale. J Am Geriatr Soc. 2016;64(11):e207–e12.PubMedCrossRef Theou O, Tan EC, Bell JS, Emery T, Robson L, Morley JE, et al. Frailty levels in residential aged care facilities measured using the frailty index and FRAIL-NH scale. J Am Geriatr Soc. 2016;64(11):e207–e12.PubMedCrossRef
8.
go back to reference Thompson MQ, Theou O, Tucker GR, Adams RJ, Visvanathan R. Recurrent measurement of frailty is important for mortality prediction: findings from the north West Adelaide health study. J Am Geriatr Soc. 2019;67(11):2311–7.PubMedCrossRef Thompson MQ, Theou O, Tucker GR, Adams RJ, Visvanathan R. Recurrent measurement of frailty is important for mortality prediction: findings from the north West Adelaide health study. J Am Geriatr Soc. 2019;67(11):2311–7.PubMedCrossRef
9.
go back to reference Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75.PubMedCrossRef Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75.PubMedCrossRef
10.
go back to reference Dyer SM, v.d B. M., Barnett K, Brown A, Johnstone G, et al. Review of Innovative Models of Aged Care. Royal Commission into Aged Care Quality and Safety. 2020; Research Paper 3. Dyer SM, v.d B. M., Barnett K, Brown A, Johnstone G, et al. Review of Innovative Models of Aged Care. Royal Commission into Aged Care Quality and Safety. 2020; Research Paper 3.
12.
go back to reference Sanford AM, Orrell M, Tolson D, Abbatecola AM, Arai H, Bauer JM, et al. An international definition for "nursing home". J Am Med Dir Assoc. 2015;16(3):181–4.PubMedCrossRef Sanford AM, Orrell M, Tolson D, Abbatecola AM, Arai H, Bauer JM, et al. An international definition for "nursing home". J Am Med Dir Assoc. 2015;16(3):181–4.PubMedCrossRef
13.
go back to reference Barnett K, Moretti C, Howard S. Enabling aged care teaching and research: the TRACS footprint. J Res Nurs. 2018;23(2–3):267–87.PubMedPubMedCentral Barnett K, Moretti C, Howard S. Enabling aged care teaching and research: the TRACS footprint. J Res Nurs. 2018;23(2–3):267–87.PubMedPubMedCentral
14.
go back to reference Jorm AF, Mackinnon AJ, Henderson AS, Scott R, Christensen H, Korten AE, et al. The psychogeriatric assessment scales: a multi-dimensional alternative to categorical diagnoses of dementia and depression in the elderly. Psychol Med. 1995;25(3):447–60.PubMedCrossRef Jorm AF, Mackinnon AJ, Henderson AS, Scott R, Christensen H, Korten AE, et al. The psychogeriatric assessment scales: a multi-dimensional alternative to categorical diagnoses of dementia and depression in the elderly. Psychol Med. 1995;25(3):447–60.PubMedCrossRef
15.
go back to reference Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.PubMedCrossRef Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.PubMedCrossRef
16.
go back to reference Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. J Am Med Dir Assoc. 2015;16(6):535.e1–12.CrossRef Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. J Am Med Dir Assoc. 2015;16(6):535.e1–12.CrossRef
17.
go back to reference World Health Organization. WHO global report on falls prevention in older age. Geneva: World Health Organization; 2007. World Health Organization. WHO global report on falls prevention in older age. Geneva: World Health Organization; 2007.
18.
go back to reference Shelkey M, Wallace M. Katz index of Independence in activities of daily living (ADL). Director. 2000;8(2):72–3.PubMed Shelkey M, Wallace M. Katz index of Independence in activities of daily living (ADL). Director. 2000;8(2):72–3.PubMed
19.
go back to reference Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc. 2003;4(1):9–15.PubMedCrossRef Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale. J Am Med Dir Assoc. 2003;4(1):9–15.PubMedCrossRef
21.
go back to reference Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014;15(9):630–4.CrossRefPubMed Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014;15(9):630–4.CrossRefPubMed
22.
go back to reference Milte R, Ratcliffe J, Bradley C, Shulver W, Crotty M. Evaluating the quality of care received in long-term care facilities from a consumer perspective: development and construct validity of the consumer choice index six dimension instrument. Ageing Soc. 2019;39(1):138–60.CrossRef Milte R, Ratcliffe J, Bradley C, Shulver W, Crotty M. Evaluating the quality of care received in long-term care facilities from a consumer perspective: development and construct validity of the consumer choice index six dimension instrument. Ageing Soc. 2019;39(1):138–60.CrossRef
23.
go back to reference International Wellbeing Group. Personal wellbeing index. 5th ed. Melbourne: Australian Centre on Quality of Life, Deakin University; 2013. International Wellbeing Group. Personal wellbeing index. 5th ed. Melbourne: Australian Centre on Quality of Life, Deakin University; 2013.
24.
go back to reference Milte R, Ratcliffe J, Chen G, Crotty M. What characteristics of nursing homes are Most valued by consumers? A discrete choice experiment with residents and family members. Value Health. 2018;21(7):843–9.PubMedCrossRef Milte R, Ratcliffe J, Chen G, Crotty M. What characteristics of nursing homes are Most valued by consumers? A discrete choice experiment with residents and family members. Value Health. 2018;21(7):843–9.PubMedCrossRef
25.
go back to reference Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002;64(3):510–9.PubMedCrossRef Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002;64(3):510–9.PubMedCrossRef
26.
go back to reference St George RJ, Delbaere K, Williams P, Lord SR. Sleep quality and falls in older people living in self- and assisted-care villages. Gerontology. 2009;55(2):162–8.PubMedCrossRef St George RJ, Delbaere K, Williams P, Lord SR. Sleep quality and falls in older people living in self- and assisted-care villages. Gerontology. 2009;55(2):162–8.PubMedCrossRef
27.
go back to reference Kroenke K, Spitzer RL, Williams JB, Lowe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–21.PubMed Kroenke K, Spitzer RL, Williams JB, Lowe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–21.PubMed
28.
go back to reference Edelman P, Fulton BR, Kuhn D, Chang CH. A comparison of three methods of measuring dementia-specific quality of life: perspectives of residents, staff, and observers. Gerontologist. 2005;45 Spec No 1(1):27–36.PubMedCrossRef Edelman P, Fulton BR, Kuhn D, Chang CH. A comparison of three methods of measuring dementia-specific quality of life: perspectives of residents, staff, and observers. Gerontologist. 2005;45 Spec No 1(1):27–36.PubMedCrossRef
29.
go back to reference Tinetti ME, Ginter SF. The nursing home life-space diameter. A measure of extent and frequency of mobility among nursing home residents. J Am Geriatr Soc. 1990;38(12):1311–5.PubMedCrossRef Tinetti ME, Ginter SF. The nursing home life-space diameter. A measure of extent and frequency of mobility among nursing home residents. J Am Geriatr Soc. 1990;38(12):1311–5.PubMedCrossRef
30.
go back to reference Clark CM, Ewbank DC. Performance of the dementia severity rating scale: a caregiver questionnaire for rating severity in Alzheimer disease. Alzheimer Dis Assoc Disord. 1996;10(1):31–9.PubMed Clark CM, Ewbank DC. Performance of the dementia severity rating scale: a caregiver questionnaire for rating severity in Alzheimer disease. Alzheimer Dis Assoc Disord. 1996;10(1):31–9.PubMed
31.
go back to reference Moelter ST, Glenn MA, Xie SX, Chittams J, Clark CM, Watson M, et al. The dementia severity rating scale predicts clinical dementia rating sum of boxes scores. Alzheimer Dis Assoc Disord. 2015;29(2):158–60.PubMedPubMedCentralCrossRef Moelter ST, Glenn MA, Xie SX, Chittams J, Clark CM, Watson M, et al. The dementia severity rating scale predicts clinical dementia rating sum of boxes scores. Alzheimer Dis Assoc Disord. 2015;29(2):158–60.PubMedPubMedCentralCrossRef
32.
go back to reference Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The mini nutritional assessment. Clin Geriatr Med. 2002;18(4):737–57.PubMedCrossRef Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The mini nutritional assessment. Clin Geriatr Med. 2002;18(4):737–57.PubMedCrossRef
33.
go back to reference Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J. 2001;8(1):323–36.CrossRef Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J. 2001;8(1):323–36.CrossRef
34.
go back to reference Kaehr E, Visvanathan R, Malmstrom TK, Morley JE. Frailty in nursing homes: the FRAIL-NH scale. J Am Med Dir Assoc. 2015;16(2):87–9.PubMedCrossRef Kaehr E, Visvanathan R, Malmstrom TK, Morley JE. Frailty in nursing homes: the FRAIL-NH scale. J Am Med Dir Assoc. 2015;16(2):87–9.PubMedCrossRef
36.
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 Meausre of biological and Physosocial function. JAMA. 1963;185:914–9.PubMedCrossRef Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized Meausre of biological and Physosocial function. JAMA. 1963;185:914–9.PubMedCrossRef
37.
go back to reference Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep. 2013;24(9):10–7.PubMed Hoover M, Rotermann M, Sanmartin C, Bernier J. Validation of an index to estimate the prevalence of frailty among community-dwelling seniors. Health Rep. 2013;24(9):10–7.PubMed
40.
go back to reference Visvanathan R, Amare AT, Wesselingh S, et al. Prolonged wait time prior to entry to home care packages increases the risk of mortality and transition to permanent residential aged care services: findings from the registry of older south Australians (ROSA). J Nutr Health Aging. 2019;23(3):271–80.PubMedCrossRef Visvanathan R, Amare AT, Wesselingh S, et al. Prolonged wait time prior to entry to home care packages increases the risk of mortality and transition to permanent residential aged care services: findings from the registry of older south Australians (ROSA). J Nutr Health Aging. 2019;23(3):271–80.PubMedCrossRef
41.
go back to reference Tan EC, Visvanathan R, Hilmer SN, Vitry A, Emery T, Robson L, et al. Analgesic use and pain in residents with and without dementia in aged care facilities: a cross-sectional study. Australas J Ageing. 2016;35(3):180–7.PubMedCrossRef Tan EC, Visvanathan R, Hilmer SN, Vitry A, Emery T, Robson L, et al. Analgesic use and pain in residents with and without dementia in aged care facilities: a cross-sectional study. Australas J Ageing. 2016;35(3):180–7.PubMedCrossRef
42.
go back to reference Helvik AS, Engedal K, Benth JŠ, Selbæk G. Prevalence and severity of dementia in nursing home residents. Dement Geriatr Cogn Disord. 2015;40(3–4):166–77.PubMedCrossRef Helvik AS, Engedal K, Benth JŠ, Selbæk G. Prevalence and severity of dementia in nursing home residents. Dement Geriatr Cogn Disord. 2015;40(3–4):166–77.PubMedCrossRef
43.
go back to reference Lind KE, Raban MZ, Brett L, et al. Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study. Popul Health Metr. 2020;18:25.PubMedPubMedCentralCrossRef Lind KE, Raban MZ, Brett L, et al. Measuring the prevalence of 60 health conditions in older Australians in residential aged care with electronic health records: a retrospective dynamic cohort study. Popul Health Metr. 2020;18:25.PubMedPubMedCentralCrossRef
44.
go back to reference Bell SP, Vasilevskis EE, Saraf AA, Jacobsen JML, Kripalani S, Mixon AS, et al. Geriatric syndromes in hospitalized older adults discharged to skilled nursing facilities. J Am Geriatr Soc. 2016;64(4):715–22.PubMedPubMedCentralCrossRef Bell SP, Vasilevskis EE, Saraf AA, Jacobsen JML, Kripalani S, Mixon AS, et al. Geriatric syndromes in hospitalized older adults discharged to skilled nursing facilities. J Am Geriatr Soc. 2016;64(4):715–22.PubMedPubMedCentralCrossRef
46.
go back to reference Ambagtsheer RC, Beilby J, Seiboth C, Dent E. Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study. Aging Clin Exp Res. 2020;32(9):1849–56.PubMedCrossRef Ambagtsheer RC, Beilby J, Seiboth C, Dent E. Prevalence and associations of frailty in residents of Australian aged care facilities: findings from a retrospective cohort study. Aging Clin Exp Res. 2020;32(9):1849–56.PubMedCrossRef
Metadata
Title
The Frailty In Residential Sector over Time (FIRST) study: methods and baseline cohort description
Authors
Agathe Daria Jadczak
Leonie Robson
Tina Cooper
J. Simon Bell
Renuka Visvanathan
on behalf of the FIRST Study Collaborators
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01974-1

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