Volume 5, Issue 2 (December 2019)                   Elderly Health Journal 2019, 5(2): 92-101 | Back to browse issues page


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Mousavisisi M, Shamshirgaran S M, Rezaeipandari H, Matlabi H. Multidimensional Approach to Frailty among Rural Older People: Applying the Tilburg Frailty Indicator. Elderly Health Journal 2019; 5 (2) :92-101
URL: http://ehj.ssu.ac.ir/article-1-139-en.html
Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical sciences, Tabriz, Iran
Abstract:   (2692 Views)
Introduction: Frailty is a common geriatric syndrome. Studies of frailty and old age have been able to help reduce its underlying causes and complication. Understanding the frailty and its associated factors in developing countries such as Iran, can help gather information on conditions of the elderly and better plan for this age population. Therefore, the present study was implemented to investigate the prevalence and determinants of frailty in the rural elderly population of Shabestar, East Azarbayjan, Iran.
 
Methods: This cross-sectional study was conducted among 565 rural older people in Shabestar, Iran during 2018-2019. The data collection tool was the Tilburg Frailty Indicator. The participants were selected by using stratified and simple random approach. Descriptive statistics, t-test, one-way ANOVA and logistic regression were used to perform data analysis.
 
Results: Of the participants, 46.7% were detected as being frail. The associations between the prevalence of frailty and sociodemographic characteristics such as age, gender, marital status, types of lifestyle, educational level, and income status were statistically significant (p < 0.05). Regression analysis showed that age (β = -0.84, p < 0.05), the number of medications used (β = -2.72, p < 0.001), hypertension (β = -0.633, p < 0.006), diabetes (β = -535, p < 0.045) and the history of fall during the last year (β = -4.21, p < 0.001) were the most important predictors of frailty among non-institutionalized rural older people.
 
Conclusion: The study confirms the importance of common chronic medical conditions and sociodemographic characteristics in the development of frailty syndrome among older adults. The descriptive nature of the study implies observational trials to clarify more deeply relationship between frailty and the determinants found.
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Type of Study: Research | Subject: Special
Received: 2019/01/7 | Accepted: 2019/10/1 | Published: 2019/12/29

References
1. Wiener JM, Hanley RJ. Measuring the activities of daily living among the elderly: a guide to national surveys. US Department of Health and Human Services. 2007:1-22.
2. Selection of the results of the general census of population and housing in Iran in 2016. Statistical Center of Iran; 2017. Available from: https://www.amar.org.ir/english/Population-and-Housing-Censuses.
3. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013; 381(9868): 752-62.
4. van Assen MA, Pallast E, Fakiri FE, Gobbens RJ. Measuring frailty in Dutch community-dwelling older people: reference values of the Tilburg Frailty Indicator (TFI). Archives of Gerontology and Geriatrics. 2016; 67: 120-9.
5. Moritz I, Stein CLE, Ageing W. A life course perspective of maintaining independence in older age prepared for WHO by Inka Moritz and Claudia Stein under the guidance of WHO's Ageing and Health. 1999.
6. Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, et al. Frailty: an emerging research and clinical paradigm—issues and controversies. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007; 62(7): 731-7.
7. Coelho T, Paúl C, Gobbens RJ, Fernandes L. Determinants of frailty: the added value of assessing medication. Frontiers in Aging Neuroscience. 2015; 7: 1-8.
8. Morley JE, Vellas B, Van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. Journal of the American Medical Directors Association. 2013; 14(6): 392-7.
9. Kojima G. Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. Journal of the American Medical Directors Association. 2015; 16(12): 1027-33.
10. Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2007; 62(7): 722-7.
11. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001; 56(3): 146-57.
12. Song X, Mitnitski A, Rockwood K. Prevalence and 10‐year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society. 2010; 58(4): 681-7.
13. Runzer-Colmenares FM, Samper-Ternent R, Al Snih S, Ottenbacher KJ, Parodi JF, Wong R. Prevalence and factors associated with frailty among Peruvian older adults. Archives of Gerontology and Geriatrics. 2014; 58(1): 69-73.
14. Sánchez‐García S, Sánchez‐Arenas R, García‐Peña C, Rosas‐Carrasco O, Ávila‐Funes JA, Ruiz‐Arregui L, et al. Frailty among community‐dwelling elderly Mexican people: Prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatrics & Gerontology International. 2014; 14(2): 395-402.
15. Moreira VG, Lourenço RA. Prevalence and factors associated with frailty in an older population from the city of Rio de Janeiro, Brazil: the FIBRA-RJ Study. Clinics. 2013; 68(7): 979-85.
16. Strawbridge WJ, Shema SJ, Balfour JL, Higby HR, Kaplan GA. Antecedents of frailty over three decades in an older cohort. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences. 1998; 53(1): 9-16.
17. Gale CR, Cooper C, Aihie Sayer A. Prevalence of frailty and disability: findings from the english longitudinal study of ageing. Age and Ageing. 2015; 44(1): 162-5.
18. Nguyen TN, Cumming RG, Hilmer SN. A review of frailty in developing countries. The Journal of Nutrition, Health & Aging. 2015; 19(9): 941-6.
19. Abdi M, Dabiran S. Validity and reliability of Tilburg frailty indicatr in assess of prevalence and risk factors of this syndrome in Iranian elderly. In: The First Iranian Congress of Social Medicine. 2017 Feb 14-18; Tehran, Iran. p. 65. [Persian]
20. Espinoza SE, Hazuda HP. Frailty in Older Mexican‐American and European‐American Adults: is there an ethnic disparity?. Journal of the American Geriatrics Society. 2008; 56(9): 1744-9.
21. Santos-Eggimann B, Cuénoud P, Spagnoli J, Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. The Journals of Gerontology. 2009; 64(6): 675-81.
22. Hirsch C, Anderson ML, Newman A, Kop W, Jackson S, Gottdiener J, et al. The association of race with frailty: the cardiovascular health study. Annals of epidemiology. 2006; 16(7): 545-53.
23. Song X, MacKnight C, Latta R, Mitnitski AB, Rockwood K. Frailty and survival of rural and urban seniors: results from the Canadian Study of Health and Aging. Aging clinical and experimental research. 2007; 19(2): 145-53.
24. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community‐dwelling older persons: a systematic review. Journal of the American Geriatrics Society. 2012; 60(8): 1487-92.
25. Hoogendijk EO, van Hout HP, Heymans MW, van der Horst HE, Frijters DH, van Groenou MIB, et al. Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Annals of epidemiology. 2014; 24(7): 538-44.
26. Szanton SL, Seplaki CL, Thorpe RJ, Allen JK, Fried LP. Socioeconomic status is associated with frailty: the Women’s Health and Aging Studies. Journal of Epidemiology & Community Health. 2010; 64(1): 63-7.
27. Herr M, Robine J-M, Aegerter P, Arvieu J-J, Ankri J. Contribution of socioeconomic position over life to frailty differences in old age: comparison of life-course models in a French sample of 2350 old people. Annals of Epidemiology. 2015; 25(9): 674-80.
28. Romero‐Ortuno R. Frailty Index in Europeans: association with determinants of health. Geriatrics & Gerontology International. 2014; 14(2): 420-9.
29. Yu P, Song X, Shi J, Mitnitski A, Tang Z, Fang X, et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Archives of Gerontology and Geriatrics. 2012; 54(1): 3-8.
30. Shamshirgaran SM, Ghorbani Z. Prevalence of hypertension and pre-hypertension among people 35 and older in Khameneh: results of pilot phase of Azar cohort study. In: Proceeding of the 8th Iranian Epidemiology Congress and the 1st International Congress of Clinical Epidemiology; 2016 April 27-29; Ilam, Iran, 2016.
31. Ghorbani Z, Shamshirgaran SM, Ghafari S, Najafipour F. Prevalence of diabetes and pre-diabetes among people 35 and older in Khameneh: results of pilot phase of Azar cohort study. In: Proceeding of the 8th Iranian Epidemiology Congress and the 1st International Congress of Clinical Epidemiology; 2016 April 27-29; Ilam, Iran, 2016.
32. Foroughan M. Jafari Z, Shirin bayan P, Ghaemi Farahani Z, Rahgozar M. Validation of mini-mental state examination (MMSE) in the elderly population of Tehran. Advances in Cognitive Science. 2008;10(2): 29-37.
33. Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. The Tilburg frailty indicator: psychometric properties. Journal of the American Medical Directors Association. 2010; 11(5): 344-55.
34. Yang F, Chen Q-W. Evaluation of frailty and influencing factors in old people in hospital institution: Evidence for a phenotype of frailty. Medicine. 2018; 97(3): 1-7.
35. de Albuquerque Sousa ACP, Dias RC, Maciel ÁCC, Guerra RO. Frailty syndrome and associated factors in community-dwelling elderly in Northeast Brazil. Archives of Gerontology and Geriatrics. 2012; 54(2): 95-101.
36. Abizanda P, Romero L, Sánchez-Jurado PM, Martínez-Reig M, Gómez-Arnedo L, Alfonso SA. Frailty and mortality, disability and mobility loss in a Spanish cohort of older adults: the FRADEA study. Maturitas. 2013; 74(1): 54-60.
37. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in older adults: a nationally representative profile in the United States. The Journals of Gerontology. 2015; 70(11): 1427-34.
38. Evenhuis HM, Hermans H, Hilgenkamp TI, Bastiaanse LP, Echteld MA. Frailty and disability in older adults with intellectual disabilities: results from the healthy ageing and intellectual disability study. Journal of the American Geriatrics Society. 2012; 60(5): 934-8.
39. Çakmur H. Frailty among elderly adults in a rural area of Turkey. Medical science monitor: international medical journal of experimental and clinical research. 2015; 21: 1232-42.
40. Puts MT, Lips P, Deeg D. Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning. Journal of Clinical Epidemiology. 2005; 58(11): 1188-98.
41. Schuurmans H, Steverink N, Lindenberg S, Frieswijk N, Slaets JP. Old or frail: what tells us more? The Journals of Gerontology. 2004; 59(9): 962-5.
42. Purser JL, Kuchibhatla MN, Fillenbaum GG, Harding T, Peterson ED, Alexander KP. Identifying frailty in hospitalized older adults with significant coronary artery disease. Journal of the American Geriatrics Society. 2006; 54(11): 1674-81.
43. Alvarado BE, Zunzunegui M-V, Béland F, Bamvita J-M. Life course social and health conditions linked to frailty in Latin American older men and women. The Journals of Gerontology. 2008; 63(12): 1399-406.
44. Gruenewald TL, Seeman TE, Karlamangla AS, Sarkisian CA. Allostatic load and frailty in older adults. Journal of the American Geriatrics Society. 2009; 57(9): 1525-31.
45. Ng TP, Feng L, Nyunt MS, Larbi A, Yap KB. Frailty in older persons: multisystem risk factors and the Frailty Risk Index (FRI). Journal of the American Medical Directors Association. 2014; 15(9): 635-42.
46. Aspray T, Yarnall A, Croxson S, Chillala J, Sinclair A. British Geriatrics Society. Best Practice Guide. Diabetes. 2009.
47. Garcia-Garcia FJ, Avila GG, Alfaro-Acha A, Andres MA, Aparicio ME, Aparicio SH, et al. The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging. The Journal of Nutrition, Health & Aging. 2011; 15(10): 852-6.
48. Lee JS, Auyeung T-W, Leung J, Kwok T, Woo J. Transitions in frailty states among community-living older adults and their associated factors. Journal of the American Medical Directors Association. 2014; 15(4): 281-6.
49. Theou O, Rockwood MR, Mitnitski A, Rockwood K. Disability and co-morbidity in relation to frailty: how much do they overlap? Archives Of Gerontology And Geriatrics. 2012; 55(2): 1-8.
50. Shi J, Song X, Yu P, Tang Z, Mitnitski A, Fang X, et al. Analysis of frailty and survival from late middle age in the Beijing Longitudinal Study of Aging. BMC Geriatrics. 2011; 11(17): 2-8.
51. Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women's health and aging studies. The Journals of Gerontology. 2006; 61(3): 262-6.
52. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, Stone KL, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of Internal Medicine. 2008; 168(4): 382-9.
53. Rockwood K, Howlett SE, MacKnight C, Beattie BL, Bergman H, Hébert R, et al. Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. The Journals of Gerontology. 2004; 59(12): 1310-7.
54. Jürschik P, Nunin C, Botigué T, Escobar MA, Lavedán A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Archives of Gerontology And Geriatrics. 2012; 55(3): 625-31.
55. Shamliyan T, Talley KM, Ramakrishnan R, Kane RL. Association of frailty with survival: a systematic literature review. Ageing Research Reviews. 2013; 12(2): 719-36.
56. Biritwum R, Minicuci N, Yawson A, Theou O, Mensah G, Naidoo N, et al. Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas. 2016; 91: 8-18.
57. Rockwood K, Theou O. Frailty in aging: biological, clinical and social implications. Interdisciplinary Topics in Gerontology and Geriatrics. 2015; 41.
58. Ferrucci L, Cavazzini C, Corsi A, Bartali B, Russo C, Lauretani F, et al. Biomarkers of frailty in older persons. Journal of endocrinological investigation. 2002; 25(10): 10-15.
59. Cassel CK, Leipzig R, Cohen HJ, Larson EB, Meier DE. Geriatric medicine: an evidence-based approach: New York: Springer; 2003.
60. Kirkwood TB. Understanding the odd science of aging. Cell. 2005; 120(4): 437-47.
61. Rockwood K. What would make a definition of frailty successful?. Age and Ageing. 2005; 34(5): 432-4.

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