title: Impairments in mobility and balance in relation to frailty.
abstract: We set out to describe the relationship between impaired balance, mobility and frailty, and relate these to risk of death. We examined a subsample of 1295 community-dwelling non-demented adults from the second wave of the Canadian Study of Health and Aging (CSHA), a prospective population-based cohort study. Frailty index (FI) scores were constructed from a standardized comprehensive geriatric assessment (FI-CGA). History of mobility impairments and falls were assessed. Timed-up-and-go (TUG) and functional reach (FR) performance were measured. The CSHA clinical frailty scale (CFS) was judged by a physician. Adverse outcomes were determined at CSHA-3, conducted 5 years later. The FI-CGA varied in association with impaired mobility and balance. A history of mobility problems was demonstrable at FI-CGA scores >0.12. This level of frailty also represented the most marked deterioration in performance measures (TUG and FR). FI-CGA scores best predicted mortality (HR 1.04±0.02), proving to be a dominating factor in multivariate regression models that included mobility and balance markers. Only at the upper range of FI-CGA reported (>0.45) did all participants demonstrate mobility impairment. Impaired balance and mobility contribute to frailty, but neither is sufficient to define a participant as frail.
authors.affiliation: Geriatric Medicine Research Unit, Dalhousie University, 1421-5955 Veterans Memorial Lane, Halifax, Nova Scotia, B3H 2E1 Canada.
authors.forename: Daniel H J
authors.initials: DH
authors.lastname: Davis
authors.forename: Michael R H
authors.initials: MR
authors.lastname: Rockwood
authors.forename: Arnold B
authors.initials: AB
authors.lastname: Mitnitski
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies