A roadmap of aging in Russia: the prevalence of frailty in community-dwelling older adults in the St. Petersburg district--the "Crystal" study.

OBJECTIVES: To categorize the health problems of older Russians and identify the number of frail older adults using different approaches.
DESIGN: Cross-sectional study.
SETTING: The Kolpino district of St. Petersburg. PARTICIPANTS: A random sample of 611 community-dwelling adults aged 65 and older was selected from a population-based register and stratified into two age groups (65-74, ≥75). MEASUREMENTS: Anthropometry, medical history, nutritional status, Physical Performance Battery, activities of daily living, grip strength, spirometry, renal function, 15-item Geriatric Depression Scale, Mini-Mental State Examination, and sense of coherence.
RESULTS: The female:male ratio was 2.5:1; 19% were malnourished or at risk for malnutrition, and 78.6% presented with one to three chronic pathologies, with no differences according to age or sex. Problems with hearing (60.7%), vision (89.5%), and incontinence (40.9%) were highly prevalent. Moreover, 25.9% of the younger group (65-74) and 42.5% of the older group (≥75) were found to be at risk for depression. Mild to severe cognitive impairment was found in 34.5% of the participants, and 14.4% of those aged 65 to 74 and 33.0% of those aged 75 and older reported dependence in daily living activities. The prevalence of frailty assessed using different models varied from 21.1% to 43.9%. The Fried model revealed the strongest associations with the frailty outcomes (dependence and performance). No significant differences between the sexes were found in either age group (P=.82), although the percentage of frail women increased with age (P=.001).
CONCLUSION: The findings emphasize the need for attention and resources to be shifted from disease-oriented to functional approaches in the older Russian population. The population studied is consistent with the Fried model, in which one in five older adults can be labeled as frail.