Fabio Castellana1, Luisa Lampignano1, Ilaria Bortone1, Roberta Zupo1, Madia Lozupone2, Chiara Griseta1, Antonio Daniele3, Giovanni De Pergola1, Gianluigi Giannelli4, Rodolfo Sardone1, Francesco Panza5. 1. Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy. 2. Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy. 3. Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy; Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 4. Scientific Direction, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy. 5. Healthy Aging Phenotypes Research Unit - "Salus in Apulia Study" - National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Bari, Italy. Electronic address: f_panza@hotmail.com.
Abstract
OBJECTIVES: We first estimated the prevalence of physical frailty in older subjects from the population-based Salus in Apulia Study (Apulia, Southern Italy), and its impact on all-cause mortality. Second, we explored the relationship between multimorbidity and physical frailty. DESIGN: Cross-sectional and longitudinal analyses from a population-based study. SETTING AND PARTICIPANTS: We analyzed data from the Salus in Apulia study, a population-based sample of 1929 subjects aged 65 years and older. METHODS: These older participants underwent clinical, physical, and laboratory assessments. Physical frailty was operationalized using slightly modified Fried criteria. Multimorbidity status was defined as the co-presence of 2 or more chronic conditions. RESULTS: The overall prevalence of physical frailty in this older population from Southern Italy was 14.8% [95% confidence interval (CI): 13.26-16.49]. Physical frailty subjects were significantly older (P < .01), had a lower educational level (P < .01), increased executive dysfunction (P < .01), higher serum levels interleukin-6 (P < .01), and white blood cells (P = .01). Multimorbidity status (P < .01), diabetes mellitus (P = .05), peripheral age-related hearing loss (P < .01), cognitive impairment (P < .01), chronic obstructive pulmonary disease (P = .02), and metabolic syndrome (P = .02) were also directly related to physical frailty. Apathy increased according to the severity of physical frailty status (P = .02). There was a significant increased risk of all-cause mortality for physical frailty subjects (hazard ratio: 1.48; 95% CI: 1.03-2.12, adjusted for age and sex) during the observation from the date of enrollment to the date of death (mean ± SD: 55.70 ± 22.19 months, median: 54 months). CONCLUSIONS AND IMPLICATIONS: Frailty is the consequence of the contributory action of the aging process and some chronic diseases that hasten some of the changes concurrent with aging.
OBJECTIVES: We first estimated the prevalence of physical frailty in older subjects from the population-based Salus in Apulia Study (Apulia, Southern Italy), and its impact on all-cause mortality. Second, we explored the relationship between multimorbidity and physical frailty. DESIGN: Cross-sectional and longitudinal analyses from a population-based study. SETTING AND PARTICIPANTS: We analyzed data from the Salus in Apulia study, a population-based sample of 1929 subjects aged 65 years and older. METHODS: These older participants underwent clinical, physical, and laboratory assessments. Physical frailty was operationalized using slightly modified Fried criteria. Multimorbidity status was defined as the co-presence of 2 or more chronic conditions. RESULTS: The overall prevalence of physical frailty in this older population from Southern Italy was 14.8% [95% confidence interval (CI): 13.26-16.49]. Physical frailty subjects were significantly older (P < .01), had a lower educational level (P < .01), increased executive dysfunction (P < .01), higher serum levels interleukin-6 (P < .01), and white blood cells (P = .01). Multimorbidity status (P < .01), diabetes mellitus (P = .05), peripheral age-related hearing loss (P < .01), cognitive impairment (P < .01), chronic obstructive pulmonary disease (P = .02), and metabolic syndrome (P = .02) were also directly related to physical frailty. Apathy increased according to the severity of physical frailty status (P = .02). There was a significant increased risk of all-cause mortality for physical frailty subjects (hazard ratio: 1.48; 95% CI: 1.03-2.12, adjusted for age and sex) during the observation from the date of enrollment to the date of death (mean ± SD: 55.70 ± 22.19 months, median: 54 months). CONCLUSIONS AND IMPLICATIONS: Frailty is the consequence of the contributory action of the aging process and some chronic diseases that hasten some of the changes concurrent with aging.