Around one in six community-dwelling older Australians may be living with clinical frailty, an Australian analysis of global data suggests.
The study found that 4.3 per cent of older people living in the community become frail every year and another 15 per cent become prefrail, says Richard Ofori-Asenso from Department of Epidemiology and Preventive Medicine at Monash University.
It’s the first time frailty has been assessed on a global population level, despite it being a condition commonly affecting older people and an increase in frailty-related research over the last ten years.
A clinical condition
Fraility is characterised by a decline in function and often associated with weight loss, exhaustion, slowness and low physical activity.
It can manifest as an inability to tolerate stressful events and brings with it an increased risk of falls, delirium, institutionalization, disability and death. Frailty is also associated with poor outcomes after surgery and higher health care costs.
The study also identifies an “identifiable intermediate stage” of frailty known as “prefraility”.
While older people are at increased risk of fraility, it isn’t an inevitable part of ageing, Professor Danny Liew, who supervised the research, told Community Care Review.
“Frailty is a dynamic condition, it doesn’t necessarily mean a one-way street, people can move in and out of it,” he says. “It’s not curable but it’s certainly not something that people are committed to forever.”
Protein supplementation and strength training ranked highest for preventing frailty, the study found.
Mild intensity exercise and education had “midzone” effectiveness while geriatric assessment and home visits were least effective.
Interventions aimed at pre-empting frailty and prefrailty in healthy populations could be important, the study concluded.
A review of 120,000 people
The study reviewed data involving more than 120,000 people aged over 60 from 28 countries, with a total of 46 studies from around the world, including four from Australia used for the final analysis.
The Australian results were in line with findings from other countries.
The results suggest that the risk of developing frailty and prefrailty is high among community living older adults, pointing to the need for appropriate interventions, the study says.
The incidence of frailty is also higher in lower and middle income countries than high income countries, with some studies suggesting frailty can be mitigated by education and income providing better access to healthcare.
There’s also a higher incidence of frailty and prefrailty in women than in men, but women are better able to tolerate it and have lower death rates than men.
“Improved understanding of the incidence of frailty may help deepen the discourse around the maintenance of functional ability in old age,” the study says.
Frailty often exists alongside other health problems, making it difficult to diagnose and screen for, Mr Ofori-Asenso says, and global comparisons complicated by the lack of a single definition of frailty.
“One of the challenges that contributes to global variation are varying measures for frailty,” he told CCR.
“We believe that if there’s a global consensus on one specific criteria then it makes it easier to compare and see trends over time.
“At the moment we don’t have a generalised criteria that we can use to measure or assess frailty.”
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