Frailty and its association with disability and comorbidity in a community-dwelling sample of seniors in Montreal: a cross-sectional study.
OBJECTIVE
The term frailty is used to describe older persons at high risk for adverse health outcomes. In 2001, Fried et al. proposed a now widely cited definition which suggests that frailty is a clinical entity related to, but distinct from, ADL disability and comorbidity. Frailty status was assessed based on the presence of any three of the following five characteristics: shrinking, weakness, poor endurance, slowness, and low activity. The objectives of the current study are to estimate the prevalence of frailty in a sample of community-dwelling older persons, to identify sociodemographic and health variables associated with frailty, and to examine the complex relationships between frailty and comorbidity, ADL disability and IADL disability.


METHODS
This study is based on cross-sectional analysis of 740 community-dwelling seniors from the Montreal Unmet Needs Study (MUNS). The five characteristics of frailty were operationalised using measures available in MUNS. The Cochran-Mantel-Haenszel test was used to identify variables associated with frailty. Overlaps between frailty, comorbidity and disability were assessed using proportions.


RESULTS
Overall, 7.4% were classified as frail, 49.7% prefrail and 42.8% non-frail. Frailty was associated with age, sex, income, education, number of chronic diseases, ADL disability, and IADL disability. Among those classified as frail, 29.1% had disabilities in ADLs, 92.7% in IADLs and 81.8% had comorbidity.


CONCLUSIONS
Findings on the relationship between frailty and sociodemographic variables, morbidity and disability, support previous studies, providing further evidence that although frailty seems to be a distinct geriatric concept, it also overlaps with other concepts.
Wong
Chek Hooi
CH
McGill/University of Montreal Solidage Research Group, Montreal, Canada.
Weiss
Deborah
D
Sourial
Nadia
N
Karunananthan
Sathya
S
Quail
Jacqueline M
JM
Wolfson
Christina
C
Bergman
Howard
H
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity / Q000639:trends*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006304:Health Status; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007182:Income; D008297:Male; D017533:Marital Status; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012649:Self Concept; D012959:Socioeconomic Factors; D014652:Vascular Diseases / Q000453:epidemiology