title: Frailty and use of health and community services by community-dwelling older men: the Concord Health and Ageing in Men Project.
abstract: BACKGROUND
  frailty is a concept used to describe older people at high risk of adverse outcomes, including falls, functional decline, hospital or nursing home admission and death. The associations between frailty and use of specific health and community services have not been investigated.
  
  
  METHODS
  the cross-sectional relationship between frailty and use of several health and community services in the last 12 months was investigated in 1,674 community-dwelling men aged 70 or older in the Concord Health and Ageing in Men study, a population-based study conducted in Sydney, Australia. Frailty was assessed using a modified version of the Cardiovascular Health Study criteria.
  
  
  RESULTS
  overall, 158 (9.4%) subjects were frail, 679 (40.6%) were intermediate (pre-frail) and 837 (50.0%) were robust. Frailty was associated with use of health and community services in the last 12 months, including consulting a doctor, visiting or being visited by a nurse or a physiotherapist, using help with meals or household duties and spending at least one night in a hospital or nursing home. Frail men without disability in activities of daily living were twice more likely to have seen a doctor in the previous 2 weeks than robust men (adjusted odds ratio 2.04, 95% confidence interval 1.21-3.44), independent of age, comorbidity and socio-economic status.
  
  
  CONCLUSIONS
  frailty is strongly associated with use of health and community services in community-dwelling older men. The high level of use of medical services suggests that doctors and nurses could play a key role in implementation of preventive interventions.
authors.affiliation: Service of Geriatric Medicine & Geriatric Rehabilitation, University of Lausanne Hospital Center, Lausanne, Switzerland.
authors.forename: Stephane
authors.initials: S
authors.lastname: Rochat
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Fiona
authors.initials: F
authors.lastname: Blyth
authors.forename: Helen
authors.initials: H
authors.lastname: Creasey
authors.forename: David
authors.initials: D
authors.lastname: Handelsman
authors.forename: David G
authors.initials: DG
authors.lastname: Le Couteur
authors.forename: Vasi
authors.initials: V
authors.lastname: Naganathan
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Seibel
authors.forename: Louise
authors.initials: L
authors.lastname: Waite
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D012111:Residence Characteristics; D011795:Surveys and Questionnaires