Longitudinal changes in frailty prevalence and related factors in older adults living in long‐term care facilities

• Published in: Journal of advanced nursing 2020-07, Vol.76 (7), p.1679-1690
• Main Authors: Oh, Eunmi, Moon, SeolHwa, Hong, Gwi‐Ryung S.
• Format: Article
• Language: English
• Subjects: Activities of daily living; Change agents; Chronic illnesses; Cohort analysis; Frail; frail older people; Frailty; Functional impairment; Longitudinal studies; Multivariate analysis; Nursing; Nutritional status; Older people; prevalence; residential facilities; risk factors
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.14388

Aims To investigate longitudinal changes in the prevalence of frailty and related factors in older adults residing in long‐term care facilities (LTCFs) in Korea. Design A longitudinal cohort study design. Methods Three hundred and fifty adults (aged 65 and older) residing in 10 LTCFs between January 2014 and January 2016 in Korea were initially investigated. Among these, 182 participants were included in the final analysis. Fried's Cardiovascular Health Study index was used to assess frailty based on Freiheit and colleagues. Data analysed included descriptive statistics and repeated‐measures multivariate analysis of variance. Results The prevalence of frailty was 25.8%, 33.5% and 35.2% in 2014, 2015 and 2016, respectively. Differences in dependence of activities of daily living, number of chronic diseases, nutritional status and depression were statistically significant among the normal, pre‐frail and frail groups at each year. Overall, from 2014–2016, the percentage of older adults decreased from 9.4–6.0% in the normal group and from 64.8%–58.8% in the pre‐frail group, while increasing in the frail group from 25.8%–35.2%. Conclusion The prevalence rate of frailty among older adults living in LTCFs was high and the rate of frail older adults gradually increased over time. Impact Frailty is a comprehensive health condition and a dynamic, changeable state. This longitudinal study showed a high rate of frailty and dynamic change in frailty level over time among residents. Because frailty is dynamic in every older adult over time, management should be tailored according to the individual's state of frailty to prevent functional decline. Development of a comprehensive frailty assessment tool that can easily measure not only physical frailty but also the comprehensive aspects of frailty would be useful for older adults in LTCFs. 目的 调查居住在韩国长期看护机构(LTCF)的老年人的衰弱患病率及相关因素的纵向变化。 设计 纵向队列研究设计。 方法 对2014年1月至2016年1月间居住在韩国10家长期看护机构的350名老年人(65岁及65岁以上)进行初步调查。其中,182名受访者被纳入最终的分析。根据弗赖海特及其同事的判断,使用Fried表型心血管健康研究指数评估衰弱性。已分析的数据包括描述性统计和重复测量的多变量方差分析。 结果 2014年、2015年和2016年的衰弱患病率分别为25.8%、33.5%和35.2%。正常组、衰弱前期组和衰弱组在日常生活活动依赖性、慢性病发病数、营养状况和抑郁程度等方面的差异均有统计学意义。总的来说,从2014年到2016年,正常组的老年人患病率从9.4%下降到6.0%,衰弱前期组从64.8%下降到58.8%,衰弱组从25.8%上升到35.2%。 结论 生活在长期看护机构中的老年人的衰弱患病率较高,且随着时间的推移,老年人的衰弱患病率会渐渐增长。 影响 衰弱是一种综合的健康状况,是动态多变的状态。这项纵向研究表明,随着时间的推移,其内人员的衰弱率和衰弱程度的动态变化率都很高。因为老年人的衰弱会随着时间的推移呈动态变化,所以应该根据个人的衰弱状态调整对其的管理,以防止发生功能性衰退。开发全面的衰弱性评估工具不仅可以轻松测量身体的衰弱性,而且还可以测量衰弱性的全面方面,对于生活在长期看护机构中的老年人也极为实用。