Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Frailty in the elderly increases their vulnerability and leads to a greater risk of adverse events. According to various studies, the prevalence of the frailty syndrome in persons age 65 and over ranges between 3% and 37%, depending on age and sex. Walking speed in itself is considered a simple indicator of health status and of survival in older persons. Detecting frailty in primary care consultations can help improve care of the elderly, and walking speed may be an indicator that could facilitate the early diagnosis of frailty in primary care. The objective of this work was to estimate frailty-syndrome prevalence and walking speed in an urban population aged 65 years and over, and to analyze the relationship between the two indicators from the perspective of early diagnosis of frailty in the primary care setting.

Methods

Population cohort of persons age 65 and over from two urban neighborhoods in northern Madrid (Spain). Cross-sectional analysis. Bivariate and multivariate analysis with binary logistic regression to study the variables associated with frailty. Different cut-off points between 0.4 and 1.4 m/s were used to study walking speed in this population. The relationship between frailty and walking speed was analyzed using likelihood ratios.

Results

The study sample comprised 1,327 individuals age 65 and older with mean age 75.41 ± 7.41 years; 53.4% were women. Estimated frailty in the study population was 10.5% [95% CI: 8.9-12.3]. Frailty increased with age (OR = 1.14; 95% CI: 1.10-1.19) and was associated with poor self-rated health (OR = 2.52; 95% CI: 1.43-4.44), number of drugs prescribed (OR = 1.17; 95% CI: 1.08-1.26) and disability (OR = 6.58; 95% CI: 3.92-11.05). Walking speed less than 0.8 m/s was found in 42.6% of cases and in 56.4% of persons age 75 and over. Walking speed greater than 0.9 m/s ruled out frailty in the study sample. Persons age 75 and older with walking speed <0.8 m/s are at particularly high risk of frailty (32.1%).

Conclusions

Frailty-syndrome prevalence is high in persons aged 75 and over. Detection of walking speed <0.8 m/s is a simple approach to the diagnosis of frailty in the primary care setting.

Related collections

Most cited references 17

Record: found
Abstract: found
Article: not found

Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer.

Vianda Stel, Johannes Smit, Saskia M F Pluijm … (2004)

First, to validate the LASA Physical Activity Questionnaire (LAPAQ) by a 7-day diary and a pedometer in older persons. Second, to assess the repeatability of the LAPAQ. Third, to compare the feasibility of these methods. The study was performed in a subsample (n=439, aged 69-92 years) of the Longitudinal Aging Study Amsterdam (LASA). The LAPAQ was completed twice (1998/1999, 1999/2000). Respondents completed a 7-day activity diary and wore a pedometer for 7 days (1999/2000). The LAPAQ was highly correlated with the 7-day diary (r=0.68, P<.001), and moderately with the pedometer (r=0.56, P<.001). The repeatability of the LAPAQ was reasonably good (weighted kappa: 0.65-0.75). The LAPAQ was completed in 5.7+/-2.7 min, and 0.5% of the respondents had missing values. The LAPAQ appears to be a valid and reliable instrument for classifying physical activity in older people. The LAPAQ was easier to use than the 7-day diary and pedometer.

0 comments Cited 180 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men.

Thuy-Tien Dam, Eric S Orwoll, Steven R Cummings … (2009)

To compare the validity of a parsimonious frailty index (components: weight loss, inability to rise from a chair, and poor energy (Study of Osteoporotic Fractures (SOF) index)) with that of the more complex Cardiovascular Health Study (CHS) index (components: unintentional weight loss, low grip strength, poor energy, slowness, and low physical activity) for prediction of adverse outcomes in older men. Prospective cohort study. Six U.S. centers. Three thousand one hundred thirty-two men aged 67 and older. Frailty status categorized as robust, intermediate stage, or frail using the SOF index and criteria similar to those used in CHS index. Falls were reported three times for 1 year. Disability (>or=1 new impairments in performing instrumental activities of daily living) ascertained at 1 year. Fractures and deaths ascertained during 3 years of follow-up. Analysis of area under the receiver operating characteristic curve (AUC) statistics compared for models containing the SOF index versus those containing the CHS index. Greater evidence of frailty as defined by either index was associated with greater risk of adverse outcomes. Frail men had a higher age-adjusted risk of recurrent falls (odds ratio (OR)=3.0-3.6), disability (OR=5.3-7.5), nonspine fracture (hazard ratio (HR)=2.2-2.3), and death (HR=2.5-3.5) (P<.001 for all models). AUC comparisons revealed no differences between models with the SOF index and models with the CHS index in discriminating falls (AUC=0.63, P=.97), disability (AUC=0.68, P=.86), nonspine fracture (AUC=0.63, P=.90), or death (AUC=0.71 for model with SOF index and 0.72 for model with CHS index, P=.19). The simple SOF index predicts risk of falls, disability, fracture, and mortality in men as well as the more-complex CHS index.

0 comments Cited 168 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.

L Donini, S Andrieu, Nicole Visser … (2009)

The use of a simple, safe, and easy to perform assessment tool, like gait speed, to evaluate vulnerability to adverse outcomes in community-dwelling older people is appealing, but its predictive capacity is still questioned. The present manuscript summarises the conclusions of an expert panel in the domain of physical performance measures and frailty in older people, who reviewed and discussed the existing literature in a 2-day meeting held in Toulouse, France on March 12-13, 2009. The aim of the IANA Task Force was to state if, in the light of actual scientific evidence, gait speed assessed at usual pace had the capacity to identify community-dwelling older people at risk of adverse outcomes, and if gait speed could be used as a single-item tool instead of more comprehensive but more time-consuming assessment instruments. A systematic review of literature was performed prior to the meeting (Medline search and additional pearling of reference lists and key-articles supplied by Task Force members). Manuscripts were retained for the present revision only when a high level of evidence was present following 4 pre-selected criteria: a) gait speed, at usual pace, had to be specifically assessed as a single-item tool, b) gait speed should be measured over a short distance, c) at baseline, participants had to be autonomous, community-dwelling older people, and d) the evaluation of onset of adverse outcomes (i.e. disability, cognitive impairment, institutionalisation, falls, and/or mortality) had to be assessed longitudinally over time. Based on the prior criteria, a final selection of 27 articles was used for the present manuscript. Gait speed at usual pace was found to be a consistent risk factor for disability, cognitive impairment, institutionalisation, falls, and/or mortality. In predicting these adverse outcomes over time, gait speed was at least as sensible as composite tools. Although more specific surveys needs to be performed, there is sufficient evidence to state that gait speed identifies autonomous community-dwelling older people at risk of adverse outcomes and can be used as a single-item assessment tool. The assessment at usual pace over 4 meters was the most often used method in literature and might represent a quick, safe, inexpensive and highly reliable instrument to be implemented.

0 comments Cited 150 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): BMC Fam Pract

Journal ID (iso-abbrev): BMC Fam Pract

Title: BMC Family Practice

Publisher: BioMed Central

ISSN (Electronic): 1471-2296

Publication date Collection: 2013

Publication date (Electronic): 19 June 2013

Volume: 14

Page: 86

Affiliations

[1 ]CS Dr. Castroviejo. Primary Care (SERMAS), Madrid, Spain

[2 ]Unidad de Medicina de Familia, Universidad Autónoma de Madrid (UAM), Madrid, Spain

[3 ]FIBHULP Hospital La Paz, Madrid, Spain

[4 ]CS Reina Victoria. Primary Care (SERMAS), Madrid, Spain

[5 ]Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain

Article

Publisher ID: 1471-2296-14-86

DOI: 10.1186/1471-2296-14-86

PMC ID: 3691628

PubMed ID: 23782891

SO-VID: c3687134-dcd7-4eb5-9815-2f54a3d15e2c

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Frailty prevalence and slow walking speed in persons age 65 and older: implications for primary care

Read this article at

Abstract

Background

Methods

Results

Conclusions

Related collections

cGMP: Generators, Effectors and Therapeutic Implications Conference

Most cited references 17

Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer.

A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men.

Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force.

Author and article information

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 16

Cited by 90

Most referenced authors 880