Marika Salminen1,2, Anna Viljanen3,4, Sini Eloranta5,6, Paula Viikari7,3, Maarit Wuorela7,3, Tero Vahlberg8, Raimo Isoaho9,10, Sirkka-Liisa Kivelä9,11, Päivi Korhonen9, Kerttu Irjala12, Minna Löppönen13, Laura Viikari7,3. 1. City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland. majosa@utu.fi. 2. Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland. majosa@utu.fi. 3. Faculty of Medicine, Department of Clinical Medicine, Unit of Geriatrics, University of Turku, Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland. 4. Municipality of Lieto Health Care Centre, Hyvättyläntie 7, 21420, Lieto, Finland. 5. Faculty of Medicine, Department of Nursing Science, University of Turku, 20014, Turku, Finland. 6. Turku University of Applied Science, Health and Well-being, Joukahaisenkatu 3, 20520, Turku, Finland. 7. City of Turku, Welfare Division, Yliopistonkatu 30, 20101, Turku, Finland. 8. Department of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland. 9. Faculty of Medicine, Department of Clinical Medicine, Unit of Family Medicine, University of Turku, 20014, Turku, Finland. 10. City of Vaasa, Social and Health Care, Ruutikellarintie 4, 65101, Vaasa, Finland. 11. Faculty of Pharmacy, Division of Social Pharmacy, University of Helsinki, 00014, Helsinki, Finland. 12. Faculty of Medicine, Department of Clinical Medicine, Unit of Clinical Chemistry, TYKSLAB, 20521, Turku, Finland. 13. City of Raisio, Social and Health Care for Elderly, Sairaalakatu 5, 21200, Raisio, Finland.
Abstract
BACKGROUND: There is a lack of agreement about applicable instrument to screen frailty in clinical settings. AIMS: To analyze the association between frailty and mortality in Finnish community-dwelling older people. METHODS: This was a prospective study with 10- and 18-year follow-ups. Frailty was assessed using FRAIL scale (FS) (n = 1152), Rockwood's frailty index (FI) (n = 1126), and PRISMA-7 (n = 1124). To analyze the association between frailty and mortality, Cox regression model was used. RESULTS: Prevalence of frailty varied from 2 to 24% based on the index used. In unadjusted models, frailty was associated with higher mortality according to FS (hazard ratio 7.96 [95% confidence interval 5.10-12.41] in 10-year follow-up, and 6.32 [4.17-9.57] in 18-year follow-up) and FI (5.97 [4.13-8.64], and 3.95 [3.16-4.94], respectively) in both follow-ups. Also being pre-frail was associated with higher mortality according to both indexes in both follow-ups (FS 2.19 [1.78-2.69], and 1.69 [1.46-1.96]; FI 1.81[1.25-2.62], and 1.31 [1.07-1.61], respectively). Associations persisted even after adjustments. Also according to PRISMA-7, a binary index (robust or frail), frailty was associated with higher mortality in 10- (4.41 [3.55-5.34]) and 18-year follow-ups (3.78 [3.19-4.49]). DISCUSSION: Frailty was associated with higher mortality risk according to all three frailty screening instrument used. Simple and fast frailty indexes, FS and PRISMA-7, seemed to be comparable with a multidimensional time-consuming FI in predicting mortality among community-dwelling Finnish older people. CONCLUSIONS: FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.
BACKGROUND: There is a lack of agreement about applicable instrument to screen frailty in clinical settings. AIMS: To analyze the association between frailty and mortality in Finnish community-dwelling older people. METHODS: This was a prospective study with 10- and 18-year follow-ups. Frailty was assessed using FRAIL scale (FS) (n = 1152), Rockwood's frailty index (FI) (n = 1126), and PRISMA-7 (n = 1124). To analyze the association between frailty and mortality, Cox regression model was used. RESULTS: Prevalence of frailty varied from 2 to 24% based on the index used. In unadjusted models, frailty was associated with higher mortality according to FS (hazard ratio 7.96 [95% confidence interval 5.10-12.41] in 10-year follow-up, and 6.32 [4.17-9.57] in 18-year follow-up) and FI (5.97 [4.13-8.64], and 3.95 [3.16-4.94], respectively) in both follow-ups. Also being pre-frail was associated with higher mortality according to both indexes in both follow-ups (FS 2.19 [1.78-2.69], and 1.69 [1.46-1.96]; FI 1.81[1.25-2.62], and 1.31 [1.07-1.61], respectively). Associations persisted even after adjustments. Also according to PRISMA-7, a binary index (robust or frail), frailty was associated with higher mortality in 10- (4.41 [3.55-5.34]) and 18-year follow-ups (3.78 [3.19-4.49]). DISCUSSION: Frailty was associated with higher mortality risk according to all three frailty screening instrument used. Simple and fast frailty indexes, FS and PRISMA-7, seemed to be comparable with a multidimensional time-consuming FI in predicting mortality among community-dwelling Finnish older people. CONCLUSIONS:FS and PRISMA-7 are applicable frailty screening instruments in clinical setting among community-dwelling Finnish older people.
Entities:
Keywords:
Association; Frailty; Mortality; Older people
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