Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort Lc65+.
OBJECTIVE
To estimate the prevalence of prefrailty, frailty, comorbidity, and disability in the youngest old and to identify chronic diseases associated with individual frailty criteria.


METHODS
Population-based cohort study of noninstitutionalized elderly adults at baseline; cross-sectional analysis.


METHODS
Lausanne, Switzerland.


METHODS
One thousand two hundred eighty-three individuals with complete data on frailty, aged 65 to 70 (58.5% women).


METHODS
Frailty was assessed according to an adaptation of Fried's criteria (shrinking, weakness, exhaustion, slowness, and low activity, three criteria needed for the diagnosis of frailty, 1 to 2 for prefrailty). Other outcomes were diseases diagnosed by a doctor (≥ 2 chronic diseases: comorbidity) and limitations in activities of daily living (ADLs, basic and instrumental).


RESULTS
At baseline, of 1,283 participants 71.1% were classified as nonfrail, 26.4% as prefrail, and 2.5% as frail. The proportion of women increased across these three groups (56.5%, 62.8%, and 71.9%, respectively; P = .01), as did the proportion of individuals with one or more chronic diseases (68.0%, 82.8%, and 90.6%, respectively; P < .001) and the proportion with basic or instrumental ADL disability (1.6%, 10.3%, and 59.4%, respectively; P < .001). Weakness (low grip strength) was the most frequent criterion (14.3%). Prefrail participants had significantly more comorbidity and ADL disability than nonfrail participants (P < .001). When present in isolation, weakness was associated with two to three times greater prevalence of coronary heart disease, other heart diseases, diabetes mellitus, and arthritis. Similarly, a significant association was identified between exhaustion and depression.


CONCLUSIONS
Prefrailty is common in the youngest old. The most prevalent frailty criterion is weakness, which is associated with cardiovascular diseases. Longitudinal studies of the evolution of prefrailty should explore the role of potential interactions between individual frailty criteria and specific chronic diseases.
Institute of Social and Preventive Medicine, University of Lausanne Hospital Center, Lausanne, Switzerland. Nadia.Danon@chuv.ch
Nadia
N
Danon-Hersch
Nicolas
N
Rodondi
Jacques
J
Spagnoli
Brigitte
B
Santos-Eggimann
D000203:Activities of Daily Living; D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009017:Morbidity / Q000639:trends*; D015995:Prevalence; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology