Anne van der Vorst1, Linda P M Op Het Veld2, Nico De Witte3, Jos M G A Schols4, Gertrudis I J M Kempen5, G A Rixt Zijlstra6. 1. Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. Electronic address: a.vandervorst@maastrichtuniversity.nl. 2. Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands. Electronic address: linda.ophetveld@zuyd.nl. 3. Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium. Electronic address: nico.dewitte@hogent.be. 4. Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. Electronic address: jos.schols@maastrichtuniversity.nl. 5. Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. Electronic address: g.kempen@maastrichtuniversity.nl. 6. Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. Electronic address: r.zijlstra@maastrichtuniversity.nl.
Abstract
BACKGROUND: Dependency in activities of daily living (ADL) might be caused by multidimensional frailty. Prevention is important as ADL dependency might threaten the ability to age in place. Therefore, this study aimed to assess whether protective factors, derived from a systematic literature review, moderate the relationship between multidimensional frailty and ADL dependency, and whether this differs across age groups. METHODS: A longitudinal study with a follow-up after 24 months was conducted among 1027 community-dwelling people aged ≥65 years. Multidimensional frailty was measured with the Tilburg Frailty Indicator, and ADL dependency with the ADL subscale from the Groningen Activity Restriction Scale. Other measures included socio-demographic characteristics and seven protective factors against ADL dependency, such as physical activity and non-smoking. Logistic regression analyses with interaction terms were conducted. RESULTS: Frail older people had a twofold risk of developing ADL dependency after 24 months in comparison to non-frail older people (OR = 2.12, 95% CI = 1.45-3.00). The selected protective factors against ADL dependency did not significantly moderate this relationship. Nonetheless, higher levels of physical activity decreased the risk of becoming ADL dependent (OR = 0.67, 95% CI = 0.46-0.98), as well as having sufficient financial resources (OR = 0.49, 95% CI = 0.35-0.71). CONCLUSION: Multidimensional frail older people have a higher risk of developing ADL dependency. The studied protective factors against ADL dependency did not significantly moderate this relationship.
BACKGROUND: Dependency in activities of daily living (ADL) might be caused by multidimensional frailty. Prevention is important as ADL dependency might threaten the ability to age in place. Therefore, this study aimed to assess whether protective factors, derived from a systematic literature review, moderate the relationship between multidimensional frailty and ADL dependency, and whether this differs across age groups. METHODS: A longitudinal study with a follow-up after 24 months was conducted among 1027 community-dwelling people aged ≥65 years. Multidimensional frailty was measured with the Tilburg Frailty Indicator, and ADL dependency with the ADL subscale from the Groningen Activity Restriction Scale. Other measures included socio-demographic characteristics and seven protective factors against ADL dependency, such as physical activity and non-smoking. Logistic regression analyses with interaction terms were conducted. RESULTS: Frail older people had a twofold risk of developing ADL dependency after 24 months in comparison to non-frail older people (OR = 2.12, 95% CI = 1.45-3.00). The selected protective factors against ADL dependency did not significantly moderate this relationship. Nonetheless, higher levels of physical activity decreased the risk of becoming ADL dependent (OR = 0.67, 95% CI = 0.46-0.98), as well as having sufficient financial resources (OR = 0.49, 95% CI = 0.35-0.71). CONCLUSION: Multidimensional frail older people have a higher risk of developing ADL dependency. The studied protective factors against ADL dependency did not significantly moderate this relationship.
Authors: Ji Eun Lee; Hyejin Chun; Young Sang Kim; Hee Won Jung; Il Young Jang; Hyun Min Cha; Ki Young Son; Belong Cho; In Soon Kwon; Jong Lull Yoon Journal: J Korean Med Sci Date: 2020-01-20 Impact factor: 2.153