Frailty in community-dwelling older adults: association with adverse outcomes

Background: The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. Methods: A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (>= 60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City. Data were derived from the database of the "Cohort of Obesity, Sarcopenia and Frailty of Older Mexican Adults" (COSFOMA). Operationalization of the phenotype of frailty was performed using the criteria of Fried et al (weight loss, self-report of exhaustion, low physical activity, slow gait, and weakness). Adverse outcomes studied were limitation in basic activities of daily living (ADLs), falls and admission to emergency services in the previous year, and low quality of life (WHOQOL-OLD). Results: Frailty was identified in 20.6% (n=258), pre-frailty in 57.6% (n=721), and not frail in 21.8% (n=273). The association between frailty and limitations in ADL was odds ratio (OR)=2.3 (95% confidence interval [CI] 1.7-3.2) and adjusted OR=1.7 (95% CI 1.2-2.4); falls OR=1.6 (95% CI 1.2-2.1) and adjusted OR=1.4 (95% CI 1.0-1.9); admission to emergency services OR=1.9 (95% CI 1.1-3.1) and adjusted OR=1.9 (95% CI 1.1-3.4); low quality of life OR=3.4 (95% CI 2.6-4.6) and adjusted OR=2.1 (95% CI 1.5-2.9). Conclusion: Approximately 2 out of 10 older adults demonstrate frailty. This is associated with limitations in ADL, falls, and admission to emergency rooms during the previous year as well as low quality of life.