title: Frailty as a predictor of short-term adverse outcomes.
abstract: The objectives of this study were to compare how different frailty measures (Frailty Phenotype/FP, Groningen Frailty Indicator/GFI and Tilburg Frailty Indicator/TFI) predict short-term adverse outcomes. Secondarily, adopting a multidimensional approach to frailty (integral conceptual model-TFI), this study aims to compare how physical, psychological and social frailty predict the outcomes. A longitudinal study was carried out with 95 community-dwelling elderly. Participants were assessed at baseline for frailty, determinants of frailty, and adverse outcomes (healthcare utilization, quality of life, disability in basic and instrumental activities of daily living/ADL and IADL). Ten months later the outcomes were assessed again. Frailty was associated with specific healthcare utilization indicators: the FP with a greater utilization of informal care; GFI with an increased contact with healthcare professionals; and TFI with a higher amount of contacts with a general practitioner. After controlling for the effect of life-course determinants, comorbidity and adverse outcome at baseline, GFI predicted IADL disability and TFI predicted quality of life. The effect of the FP on the outcomes was not significant, when compared with the other measures. However, when comparing TFI's domains, the physical domain was the most significant predictor of the outcomes, even explaining part of the variance of ADL disability. Frailty at baseline was associated with adverse outcomes at follow-up. However, the relationship of each frailty measure (FP, GFI and TFI) with the outcomes was different. In spite of the role of psychological frailty, TFI's physical domain was the determinant factor for predicting disability and most of the quality of life.
authors.affiliation: School of Allied Health Technologies, Polytechnic Institute of Porto , Porto , Portugal ; UNIFAI, ICBAS, University of Porto , Porto , Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Coelho
authors.affiliation: UNIFAI, ICBAS, University of Porto , Porto , Portugal.
authors.forename: Constança
authors.initials: C
authors.lastname: Paúl
authors.affiliation: Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences , Amsterdam , The Netherlands ; Zonnehuisgroep Amstelland , Amstelveen , The Netherlands.
authors.forename: Robbert J J
authors.initials: RJ
authors.lastname: Gobbens
authors.affiliation: Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto , Porto , Portugal ; UNIFAI/CINTESIS Research Unit, Faculty of Medicine, University of Porto , Porto , Portugal.
authors.forename: Lia
authors.initials: L
authors.lastname: Fernandes
keywords: Adverse outcomes; Frailty; Frailty Phenotype; Groningen Frailty Indicator; Tilburg Frailty Indicator