Olga Theou1,2, Janet K Sluggett3, J Simon Bell1,3,4,5, Samanta Lalic3, Tina Cooper6, Leonie Robson6, John E Morley1,7, Kenneth Rockwood1,2, Renuka Visvanathan1,8,9. 1. National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, South Australia, Australia. 2. Department of Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada. 3. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia. 4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 5. Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia. 6. Resthaven Incorporated, Adelaide, South Australia, Australia. 7. Divisions of Geriatric Medicine and Endocrinology, School of Medicine, Saint Louis University, Missouri. 8. Adelaide Geriatrics Training and Research with Aged Care Centre, School of Medicine, University of Adelaide, South Australia, Australia. 9. Aged and Extended Care Services, The Queen Elizabeth Hospital, South Australia, Australia.
Abstract
Background: Frailty predicts mortality in residential aged care, but the relationship with hospitalization is inconsistent. The purpose of this study was to investigate and compare whether frailty is associated with hospitalization and mortality among residents of aged care services. Methods: A prospective cohort study of 383 residents aged 65 years and older was conducted in six Australian residential aged care services. Frailty was assessed using the FRAIL-NH scale and a 66-item frailty index. Results: Overall, 125 residents were hospitalized on 192 occasions and 85 died over the 12-month follow-up. Over this period, less than 3% of the nonfrail/vulnerable residents but more than 20% of the most frail residents died at the facility without hospitalization. Using the FRAIL-NH, residents with mild/moderate frailty had higher numbers of hospitalizations (adjusted incidence rate ratio 1.57, 95% confidence interval [CI] 1.11-2.20) and hospital days (incidence rate ratio 1.48, 95% CI 1.32-1.66) than nonfrail residents. Residents who were most frail had lower numbers of hospitalizations (incidence rate ratio 0.65, 95% CI 0.42-0.99) and hospital days (incidence rate ratio 0.39, 95% CI 0.33-0.46) than nonfrail residents. Similar patterns of associations with number of hospital days were observed for the frailty index. Most frail residents had a higher risk of death than nonfrail residents (for FRAIL-NH, adjusted hazard ratio 2.96, 95% CI 1.50-5.83; for frailty index, hazard ratio 5.28, 95% CI 2.05-13.59). Conclusions: Residents with mild/moderate frailty had higher risk of hospitalization and death than nonfrail residents. Residents who were most frail had higher risk of death but lower risk of hospitalization than nonfrail residents.
Background: Frailty predicts mortality in residential aged care, but the relationship with hospitalization is inconsistent. The purpose of this study was to investigate and compare whether frailty is associated with hospitalization and mortality among residents of aged care services. Methods: A prospective cohort study of 383 residents aged 65 years and older was conducted in six Australian residential aged care services. Frailty was assessed using the FRAIL-NH scale and a 66-item frailty index. Results: Overall, 125 residents were hospitalized on 192 occasions and 85 died over the 12-month follow-up. Over this period, less than 3% of the nonfrail/vulnerable residents but more than 20% of the most frail residents died at the facility without hospitalization. Using the FRAIL-NH, residents with mild/moderate frailty had higher numbers of hospitalizations (adjusted incidence rate ratio 1.57, 95% confidence interval [CI] 1.11-2.20) and hospital days (incidence rate ratio 1.48, 95% CI 1.32-1.66) than nonfrail residents. Residents who were most frail had lower numbers of hospitalizations (incidence rate ratio 0.65, 95% CI 0.42-0.99) and hospital days (incidence rate ratio 0.39, 95% CI 0.33-0.46) than nonfrail residents. Similar patterns of associations with number of hospital days were observed for the frailty index. Most frail residents had a higher risk of death than nonfrail residents (for FRAIL-NH, adjusted hazard ratio 2.96, 95% CI 1.50-5.83; for frailty index, hazard ratio 5.28, 95% CI 2.05-13.59). Conclusions: Residents with mild/moderate frailty had higher risk of hospitalization and death than nonfrail residents. Residents who were most frail had higher risk of death but lower risk of hospitalization than nonfrail residents.
Authors: Ghalib A Bello; Katherine A Ornstein; Roberto G Lucchini; William W Hung; Fred C Ko; Elena Colicino; Emanuela Taioli; Michael A Crane; Andrew C Todd Journal: J Aging Health Date: 2021-03-12
Authors: Renly Lim; Luke Bereznicki; Megan Corlis; Lisa M Kalisch Ellett; Ai Choo Kang; Tracy Merlin; Gaynor Parfitt; Nicole L Pratt; Debra Rowett; Stacey Torode; Joseph Whitehouse; Andre Q Andrade; Rebecca Bilton; Justin Cousins; Lan Kelly; Camille Schubert; Mackenzie Williams; Elizabeth Ellen Roughead Journal: BMJ Open Date: 2020-04-22 Impact factor: 2.692
Authors: Esa Yh Chen; J Simon Bell; Jenni Ilomaki; Claire Keen; Megan Corlis; Michelle Hogan; Jan Van Emden; Sarah N Hilmer; Janet K Sluggett Journal: Clin Interv Aging Date: 2019-10-22 Impact factor: 4.458