Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty.
OBJECTIVE
To test a model of frailty by examining factors associated with institutionalization of older people in Canada; to assess whether diagnostic data provided information about risk beyond that provided by data on functional capacity and demographic variables.


METHODS
Cross-sectional study of 1258 institutional subjects and 9113 community-dwelling older adults from the Canadian Study of Health and Aging.


RESULTS
Multiple logistic regression analysis showed that female gender, being unmarried, absence of a caregiver, presence of cognitive impairment (including all types of dementia), functional impairment, diabetes mellitus, stroke, and Parkinson's disease were independently associated with being in a long-term care facility.


CONCLUSIONS
Frailty appears to be a multidimensional construct, and not simply a synonym for dependence in Activities of Daily Living. Studies of health outcomes in older people should include diagnostic data as well as demographic information and data on functional capacity.
Rockwood
K
K
Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Stolee
P
P
McDowell
I
I
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006707:Homes for the Aged; D006801:Humans; D007326:Institutionalization; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D009735:Nursing Homes