To analyze prefrailty’s relationship with limitations in activities of daily living (ADLs) and restrictions in social participation.
Method:
Robust (Fried 0/4; n = 214; Mage = 82.3 years [SD ±2.1]) and prefrail (Fried 1–2/4; n = 191; Mage = 83.8 years [SD ±3.2]) community-dwelling older individuals were included. Frailty scores were obtained from weight loss, exhaustion, gait speed, and grip strength. A total disability index (DI) expressed dependency for basic (b-), instrumental (i-), and advanced (a-)ADLs. Total participation score, being a member, total number of memberships, being a board member, level of participation, membership over time, volunteering, and formal participation represented social participation.
Results:
Logistic regression retained age (OR = 1.224; 95% CI = [1.122, 1.335]), sex (OR = 3.818; 95% CI = [2.437, 5.982]), and a-ADL-DI (OR = 1.230; 95% CI = [1.018, 1.486]) as variables significantly related to prefrailty (68.3%; χ2 = 68.25; df = 3; p < .001).
Discussion:
Subtle limitations in a-ADLs, higher age, and being a man were associated with prefrailty, revealing the possible role of personal and culturally related a-ADLs as red flags for (pre)frailty.
AlencarM. A.DiasJ. M. D.FigueiredoL. C.DiasR. C. (2015). Transitions in frailty status in community-dwelling older adults. Topics in Geriatric Rehabilitation, 31(2), 105–112. https://doi.org/10.1097/TGR.0000000000000055
2.
AlexandreT. D. S.CoronaL. P.BritoT. R. P.SantosJ. L. F.DuarteY. A. O.LebraoM. L. (2018). Gender differences in the incidence and determinants of components of the frailty phenotype among older adults: Findings from the SABE study. Journal of Aging Health, 30(2), 190–212. https://doi.org/10.1177/0898264316671228
3.
BuchmanA. S.LeurgansS. E.BoyleP. A.SchneiderJ. A.ArnoldS. E.BennettD. A. (2011). Combinations of motor measures more strongly predict adverse health outcomes in old age: The rush memory and aging project, a community-based cohort study. BMC Medicine, 9, Article 42. https://doi.org/10.1186/1741-7015-9-42
4.
BuffelT.De DonderL.PhillipsonC.DuryS.De WitteN.VerteD. (2014). Social participation among older adults living in medium-sized cities in Belgium: The role of neighbourhood perceptions. Health Promotion International, 29(4), 655–668. https://doi.org/10.1093/heapro/dat009
5.
CampbellA. J.BuchnerD. M. (1997). Unstable disability and the fluctuations of frailty. Age and Ageing, 26(4), 315–318. https://doi.org/10.1093/ageing/26.4.315
6.
Cao DinhH.BautmansI.BeyerI.MetsT.OnyemaO. O.FortiL. N.RenmansW.Vander MeerenS.JochmansK.VermeirenS.AzzopardiR. V.NjeminiR., & Gerontopole Brussels Study Group. (2018). Association between immunosenescence phenotypes and pre-frailty in older subjects: Does cytomegalovirus play a role?The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 74(4), 480–488. https://doi.org/10.1093/gerona/gly135
CollertonJ.Martin-RuizC.DaviesK.HilkensC. M.IsaacsJ.KolendaC.KirkwoodT. B. L. (2012). Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: Cross-sectional findings from the Newcastle 85+ study. Mechanisms of Ageing and Development, 133(6), 456–466. https://doi.org/10.1016/j.mad.2012.05.005
9.
CornelisE.GorusE.BeyerI.BautmansI.De VriendtP. (2017). Early diagnosis of mild cognitive impairment and mild dementia through basic and instrumental activities of daily living: Development of a new evaluation tool. PLOS Medicine, 14(3), Article e1002250. https://doi.org/10.1371/journal.pmed.1002250
10.
CostenobleA.KnoopV.VermeirenS.VellaR. A.DebainA.RossiG.BautmansI.VertéD.GorusE.De VriendtP., & Gerontopole Brussels Study Group. (2019). A comprehensive overview of activities of daily living in existing frailty instruments: A systematic literature search. The Gerontologist. Advance online publication. https://doi.org/10.1093/geront/gnz147
11.
De DonderL.BrosensD.De WitteN.BuffelT.DuryS.SmetcorenA.-S.VertéD. (2014). Lifelong learning in old age: Results from the Belgian ageing studies. Procedia—Social and Behavioral Sciences, 116, 513–517. https://doi.org/10.1016/j.sbspro.2014.01.250
12.
DeviJ. (2018). The scales of functional assessment of activities of daily living in geriatrics. Age and Ageing, 47(4), 500–502. https://doi.org/10.1093/ageing/afy050
13.
De VriendtP.GorusE.CornelisE.BautmansI.PetrovicM.MetsT. (2013). The advanced activities of daily living: A tool allowing the evaluation of subtle functional decline in mild cognitive impairment. Journal of Nutrition, Health and Aging, 17(1), 64–71. https://doi.org/10.1007/s12603-012-0381-9
14.
De VriendtP.GorusE.CornelisE.VelgheA.PetrovicM.MetsT. (2012). The process of decline in advanced activities of daily living: A qualitative explorative study in mild cognitive impairment. International Psychogeriatrics, 24(6), 974–986. https://doi.org/10.1017/S1041610211002766
15.
Dos Santos TavaresD. M.de Freitas CorreaT. A.DiasF. A.Dos Santos FerreiraP. C.Sousa PegorariM. (2017). Frailty syndrome and socioeconomic and health characteristics among older adults. Colombia Médica, 48(3), 126–131. https://doi.org/10.25100/cm.v48i3.1978
16.
DuppenD.Van der ElstM. C. J.DuryS.LambotteD.De DonderL., & D-SCOPE. (2019). The social environment’s relationship with frailty: Evidence from existing studies. Journal of Applied Gerontology, 38(1), 3–26. https://doi.org/10.1177/0733464816688310
17.
EtmanA.KamphuisC. B.van der CammenT. J.BurdorfA.van LentheF. J. (2015). Do lifestyle, health and social participation mediate educational inequalities in frailty worsening?European Journal of Public Health, 25(2), 345–350. https://doi.org/10.1093/eurpub/cku093
18.
FastameM. C.HitchcottP. K.PennaM. P. (2018). The impact of leisure on mental health of Sardinian elderly from the “blue zone”: Evidence for ageing well. Aging Clinical and Experimental Research, 30(2), 169–180. https://doi.org/10.1007/s40520-017-0768-x
19.
FolsteinM.FolsteinS. E.McHughP. R. (1975). “Mini-mental state..” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.
20.
FriedL. P.TangenC. M.WalstonJ.NewmanA. B.HirschC.GottdienerJ., Seeman, T., Tracy, R., Kop, W. J., Burke, G., McBurnie, M. A., & Cardiovascular Health Study Collaborative Research Group. (2001). Frailty in older adults: Evidence for a phenotype. Journals of Gerontology A, 56(3), M146–M156. https://doi.org/10.1093/gerona/56.3.m146
21.
GoldbergB.BrintnellE. S.GoldbergJ. (2002). The relationship between engagement in meaningful activities and quality of life in persons disabled by mental illness. Occupational Therapy in Mental Health, 18(2), 17–44. https://doi.org/10.1300/J004v18n02_03
22.
GordonE. H.PeelN. M.SamantaM.TheouO.HowlettS. E.HubbardR. E. (2017). Sex differences in frailty: A systematic review and meta-analysis. Experimental Gerontology, 89, 30–40. https://doi.org/10.1016/j.exger.2016.12.021
23.
GordonS. J.BakerN.KiddM.MaederA.GrimmerK. A. (2020). Pre-frailty factors in community-dwelling 40-75 year olds: Opportunities for successful ageing. BMC Geriatrics, 20(1), Article 96. https://doi.org/10.1186/s12877-020-1490-7
24.
GriepY.HansonL. M.VantilborghT.JanssensL.JonesS. K.HydeM. (2017). Can volunteering in later life reduce the risk of dementia? A 5-year longitudinal study among volunteering and non-volunteering retired seniors. PLOS ONE, 12(3), Article e0173885. https://doi.org/10.1371/journal.pone.0173885
25.
HaakM.LofqvistC.UllenS.HorstmannV.IwarssonS. (2019). The influence of participation on mortality in very old age among community-living people in Sweden. Aging Clinical and Experimental Research, 31(2), 265–271. https://doi.org/10.1007/s40520-018-0947-4
26.
HoogendijkE. O.RomeroL.Sanchez-JuradoP. M.Flores RuanoT.VinaJ.Rodriguez-ManasL.AbizandaP. (2019). A new functional classification based on frailty and disability stratifies the risk for mortality among older adults: The FRADEA study. Journal of the American Medical Directors Association, 20(9), 1105–1110. https://doi.org/10.1016/j.jamda.2019.01.129
27.
HsuH. C.ChangW. C. (2015). Trajectories of frailty and related factors of the older people in Taiwan. Experimental Aging Research, 41(1), 104–114. https://doi.org/10.1080/0361073X.2015.978219
KatzS.FordA. B.MoskowitzR. W.JacksonB. A.JaffeM. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. The Journal of the American Medical Association, 185, 914–919.
30.
KnoopV.CostenobleA.Vella AzzopardiR.VermeirenS.DebainA.JansenB.ScafoglieriA.BautmansI., & Gerontopole Brussels Study Group. (2019). The operationalization of fatigue in frailty scales: A systematic review. Ageing Research Review, 53, 100911. https://doi.org/10.1016/j.arr.2019.100911
31.
KojimaG. (2017). Frailty as a predictor of disabilities among community-dwelling older people: A systematic review and meta-analysis. Disability Rehabilitation, 39(19), 1897–1908. https://doi.org/10.1080/09638288.2016.1212282
32.
KwanR. Y. C.CheungD. S. K.LoS. K. L.HoL. Y. W.KatigbakC.ChaoY. Y.LiuJ. Y. W. (2019). Frailty and its association with the Mediterranean diet, life-space, and social participation in community-dwelling older people. Geriatric Nursing, 40(3), 320–326. https://doi.org/10.1016/j.gerinurse.2018.12.011
33.
LawtonM. P.BrodyE. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179–186.
34.
LevyS. S.ThrallsK. J.GobleD. J.KrippesT. B. (2020). Effects of a community-based exercise program on older adults’ physical function, activities of daily living, and exercise self-efficacy: Feeling fit club. Journal of Applied Gerontology, 39(1), 40–49. https://doi.org/10.1177/0733464818760237
35.
LindstromM.MoghaddassiM.BolinK.LindgrenB.MerloJ. (2003). Social participation, social capital and daily tobacco smoking: A population-based multilevel analysis in Malmo, Sweden. Scandinavian Journal of Public Health, 31(6), 444–450. https://doi.org/10.1080/14034940310006203
36.
LiuH. X.DingG.YuW. J.LiuT. F.YanA. Y.ChenH. Y.ZhangA. H. (2019). Association between frailty and incident risk of disability in community-dwelling elder people: Evidence from a meta-analysis. Public Health, 175, 90–100. https://doi.org/10.1016/j.puhe.2019.06.010
37.
LiuJ. Y. (2017). The severity and associated factors of participation restriction among community-dwelling frail older people: An application of the International Classification of Functioning, Disability and Health (WHO-ICF). BMC Geriatrics, 17(1), Article 43. https://doi.org/10.1186/s12877-017-0422-7
38.
Manrique-EspinozaB.Salinas-RodriguezA.de SnyderN. S.Moreno-TamayoK.Gutierrez-RobledoL. M.Avila-FunesJ. A. (2016). Frailty and social vulnerability in Mexican deprived and rural settings. Journal of Aging and Health, 28(4), 740–752. https://doi.org/10.1177/0898264315609909
39.
MelloA. d. C.EngstromE. M.AlvesL. C. (2014). Health-related and socio-demographic factors associated with frailty in the elderly: A systematic literature review. Cadernos de Saúde Pública, 30(6), 1143–1168. https://doi.org/10.1590/0102-311X00148213
40.
MorrisJ. N.BergK.FriesB. E.SteelK.HowardE. P. (2013). Scaling functional status within the interRAI suite of assessment instruments. BMC Geriatrics, 13, Article 128. https://doi.org/10.1186/1471-2318-13-128
41.
NtanasiE.YannakouliaM.MourtziN.VlachosG. S.KosmidisM. H.AnastasiouC. A.DardiotisE.HadjigeorgiouGMegalouM.SakkaP.ScarmeasN. (2020). Prevalence and risk factors of frailty in a community-dwelling population: The HELIAD study. Journal of Aging Health, 32(1), 14–24. https://doi.org/10.1177/0898264318801735
42.
Ofori-AsensoR.ChinK. L.MazidiM.ZomerE.IlomakiJ.ZulloA. R.GasevicD.AdemiZ.KorhonenM. J.LoGiudiceD.BellJ. S.LiewD. (2019). Global incidence of frailty and prefrailty among community-dwelling older adults: A systematic review and meta-analysis. JAMA Network Open, 2(8), Article e198398. https://doi.org/10.1001/jamanetworkopen.2019.8398
43.
OrmeJ. G.ReisJ.HerzE. J. (1986). Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES-D) scale. Journal of Clinical Psychology, 42(1), 28–33.
44.
OstirG. V.OttenbacherK. J.MarkidesK. S. (2004). Onset of frailty in older adults and the protective role of positive affect. Psychological Aging, 19(3), 402–408. https://doi.org/10.1037/0882-7974.19.3.402
45.
OttenbacherK. J.OstirG. V.PeekK.Al SnihS.RajiM. A.MarkidesK. S. (2006). Frailty in Mexican American older adults. Journal of the American Geriatrics Society, 53(9), 1524–1531.
RizzutoD.OrsiniN.QiuC.WangH. X.FratiglioniL. (2012). Lifestyle, social factors, and survival after age 75: Population based study. British Medical Journal, 345, Article e5568. https://doi.org/10.1136/bmj.e5568
SeinoS.KitamuraA.TomineY.TanakaI.NishiM.NonakaK.NofujiY.NaritaM.TaniguchiY.YokoyamaY.AmanoH.IkeuchiT.FujiwaraY.ShinkaiS. (2019). A community-wide intervention trial for preventing and reducing frailty among older adults living in metropolitan areas: Design and baseline survey for a study integrating participatory action research with a cluster trial. Journal of Epidemiology, 29(2), 73–81. https://doi.org/10.2188/jea.JE20170109
50.
SipersW. M.VerdijkL. B.SipersS. J.ScholsJ. M.van LoonL. J. (2016). The Martin Vigorimeter represents a reliable and more practical tool than the Jamar Dynamometer to assess handgrip strength in the geriatric patient. Journal of the American Medical Directors Association, 17(5), 466.e1–466.e7. https://doi.org/10.1016/j.jamda.2016.02.026
51.
SirolaJ.PitkalaK. H.TilvisR. S.MiettinenT. A.StrandbergT. E. (2011). Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen study. The Journal of Nutrition, Health & Aging, 15(9), 783–787. https://doi.org/10.1007/s12603-011-0131-4
52.
SternbergS. A.Wershof SchwartzA.KarunananthanS.BergmanH.Mark ClarfieldA. (2011). The identification of frailty: A systematic literature review. Journal of the American Geriatrics Society, 59(11), 2129–2138. https://doi.org/10.1111/j.1532-5415.2011.03597.x
53.
SteverinkN.SlaetsJ. P. J.SchuurmansH.van LisM. (2001). Measuring frailty: Developing and testing the GFI (Groningen frailty indicator). The Gerontologist, 41(1), 236–237.
54.
TraversJ.Romero-OrtunoR.BaileyJ.CooneyM. T. (2019). Delaying and reversing frailty: A systematic review of primary care interventions. British Journal of General Practice, 69(678), e61–e69. https://doi.org/10.3399/bjgp18X700241
55.
Van de VeldeD.CoussensM.De BaetsS.SabbeL.VanderstraetenG.VlerickP.Van MalderenL.GorusE.De VriendtP. (2018). Application of participation in clinical practice: Key issues. Journal of Rehabilitation Medicine, 50(8), 679–695. https://doi.org/10.2340/16501977-2363
56.
WalstonJ.ButaB.XueQ. L. (2018). Frailty screening and interventions: Considerations for clinical practice. Clinical Geriatric Medicine, 34(1), 25–38. https://doi.org/10.1016/j.cger.2017.09.004
57.
World Health Organization. (2001). International classification of functioning, disability and health.
YesavageJ. A.BrinkT. L.RoseT. L.LumO.HuangV.AdeyM.LeirerV. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49. https://doi.org/10.1016/0022-3956(82)90033-4
60.
ZhangQ.GuoH.GuH.ZhaoX. (2018). Gender-associated factors for frailty and their impact on hospitalization and mortality among community-dwelling older adults: A cross-sectional population-based study. PeerJ, 6, Article e4326. https://doi.org/10.7717/peerj.4326
