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Do commonly used frailty models predict mortality, loss of autonomy and mental decline in older adults in northwestern Russia? A prospective cohort study.

Turusheva A, Frolova E, Korystina E, Zelenukha D, Tadjibaev P, Gurina N, Turkeshi E, Degryse JM - BMC Geriatr (2016)

Bottom Line: The prediction of dependency and physical decline by pre-frail and frail status of any the three frailty models was not statistically significant in this cohort of older adults.Frailty by the Fried model had only limited value for mortality in those 75 years old and mental decline in those 65-75 years old.Further research is needed to identify valid frailty markers for older adults in this population.

View Article: PubMed Central - PubMed

Affiliation: Institut de Recherche Santé et Société, Université Catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte 30.05, 1200, Woluwe-Saint-Lambert, Brussels, Belgium.

ABSTRACT

Background: Frailty prevalence differs across countries depending on the models used to assess it that are based on various conceptual and operational definitions. This study aims to assess the clinical validity of three frailty models among community-dwelling older adults in north-western Russia where there is a higher incidence of cardiovascular disease and lower life expectancy than in European countries.

Methods: The Crystal study is a population-based prospective cohort study in Kolpino, St. Petersburg, Russia. A random sample of the population living in the district was stratified into two age groups: 65-75 (n = 305) and 75+ (n = 306) and had a baseline comprehensive health assessment followed by a second one after 33.4 +/-3 months. The total observation time was 47 +/-14.6 months. Frailty was assessed according to the models of Fried, Puts and Steverink-Slaets. Its association with mortality at 5 years follow-up as well as dependency, mental and physical decline at around 2.5 years follow up was explored by multivariable and time-to-event analyses.

Results: Mortality was predicted independently from age, sex and comorbidities only by the frail status of the Fried model in those over 75 years old [HR (95 % CI) = 2.50 (1.20-5.20)]. Mental decline was independently predicted only by pre-frail [OR (95 % CI) = 0.24 (0.10-0.55)] and frail [OR (95 % CI) = 0.196 (0.06-0.67)] status of Fried model in those 65-75 years old. The prediction of dependency and physical decline by pre-frail and frail status of any the three frailty models was not statistically significant in this cohort of older adults.

Conclusions: None of the three frailty models was valid at predicting 5 years mortality and disability, mental and physical decline at 2.5 years in a cohort of older adults in north-west Russia. Frailty by the Fried model had only limited value for mortality in those 75 years old and mental decline in those 65-75 years old. Further research is needed to identify valid frailty markers for older adults in this population.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the data collection of the Crystal study
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Fig1: Flowchart of the data collection of the Crystal study

Mentions: The primary care clinic (Policlinic no. 95) serves a population of 58,000 inhabitants based on a territorial concept of administration. Of that population 10,986 are aged 65 and older. As life expectancy in Russia is 64 years for men and 75 years for women largely due to the very high rate of cardiovascular mortality in working age people [1], the study population was stratified into two groups to compare those over 75 years old with the younger population (65–74 years). A representative random sample of 462 people in the younger group and 452 people in the older group was selected. No one was excluded based on health or cognitive function. The response rate was 66.2 % (n = 305) in the younger group (65–74) and 67.9 % (n = 306) in the older group (≥75). To test for sampling bias, those who agreed to participate in the study and those who were invited, but did not participate, were compared, and no significant difference was found in the sex and age distributions. Selected persons were invited to participate by telephone. Some people who were unable to come to the Policlinic were examined at home. Fourteen nurses were trained as clinical research assistants during 3 half-day training sessions to familiarize them with the questionnaires and test procedures. All data were collected from March to December 2009 (T0) (Fig. 1). A second assessment (T1) was performed an average of 33.4 ± 3 months after the date of the first data collection from February to August 2012. Out of the 611 participants included in the first assessment, 203 participants from the younger age group and 176 from the older age group were evaluable for the second assessment (102 participants died before the second assessment and 130 patients refused to participate) (Fig. 1). No difference was found between the baseline characteristics of participants who participate and who did not participate in the second assessment. The last update of mortality was in February 2014 (T2) and there was no loss of follow-up. The average total observation period of the study was 47 ± 14.6 months (T2). Other details of the sampling and data collection procedures have been already described [18]. The local ethics committee of The North-Western State Medical University named after I.I. Mechnikov approved this research for Postgraduate Studies and informed consent was obtained from all participants.Fig. 1


Do commonly used frailty models predict mortality, loss of autonomy and mental decline in older adults in northwestern Russia? A prospective cohort study.

Turusheva A, Frolova E, Korystina E, Zelenukha D, Tadjibaev P, Gurina N, Turkeshi E, Degryse JM - BMC Geriatr (2016)

Flowchart of the data collection of the Crystal study
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4862060&req=5

Fig1: Flowchart of the data collection of the Crystal study
Mentions: The primary care clinic (Policlinic no. 95) serves a population of 58,000 inhabitants based on a territorial concept of administration. Of that population 10,986 are aged 65 and older. As life expectancy in Russia is 64 years for men and 75 years for women largely due to the very high rate of cardiovascular mortality in working age people [1], the study population was stratified into two groups to compare those over 75 years old with the younger population (65–74 years). A representative random sample of 462 people in the younger group and 452 people in the older group was selected. No one was excluded based on health or cognitive function. The response rate was 66.2 % (n = 305) in the younger group (65–74) and 67.9 % (n = 306) in the older group (≥75). To test for sampling bias, those who agreed to participate in the study and those who were invited, but did not participate, were compared, and no significant difference was found in the sex and age distributions. Selected persons were invited to participate by telephone. Some people who were unable to come to the Policlinic were examined at home. Fourteen nurses were trained as clinical research assistants during 3 half-day training sessions to familiarize them with the questionnaires and test procedures. All data were collected from March to December 2009 (T0) (Fig. 1). A second assessment (T1) was performed an average of 33.4 ± 3 months after the date of the first data collection from February to August 2012. Out of the 611 participants included in the first assessment, 203 participants from the younger age group and 176 from the older age group were evaluable for the second assessment (102 participants died before the second assessment and 130 patients refused to participate) (Fig. 1). No difference was found between the baseline characteristics of participants who participate and who did not participate in the second assessment. The last update of mortality was in February 2014 (T2) and there was no loss of follow-up. The average total observation period of the study was 47 ± 14.6 months (T2). Other details of the sampling and data collection procedures have been already described [18]. The local ethics committee of The North-Western State Medical University named after I.I. Mechnikov approved this research for Postgraduate Studies and informed consent was obtained from all participants.Fig. 1

Bottom Line: The prediction of dependency and physical decline by pre-frail and frail status of any the three frailty models was not statistically significant in this cohort of older adults.Frailty by the Fried model had only limited value for mortality in those 75 years old and mental decline in those 65-75 years old.Further research is needed to identify valid frailty markers for older adults in this population.

View Article: PubMed Central - PubMed

Affiliation: Institut de Recherche Santé et Société, Université Catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte 30.05, 1200, Woluwe-Saint-Lambert, Brussels, Belgium.

ABSTRACT

Background: Frailty prevalence differs across countries depending on the models used to assess it that are based on various conceptual and operational definitions. This study aims to assess the clinical validity of three frailty models among community-dwelling older adults in north-western Russia where there is a higher incidence of cardiovascular disease and lower life expectancy than in European countries.

Methods: The Crystal study is a population-based prospective cohort study in Kolpino, St. Petersburg, Russia. A random sample of the population living in the district was stratified into two age groups: 65-75 (n = 305) and 75+ (n = 306) and had a baseline comprehensive health assessment followed by a second one after 33.4 +/-3 months. The total observation time was 47 +/-14.6 months. Frailty was assessed according to the models of Fried, Puts and Steverink-Slaets. Its association with mortality at 5 years follow-up as well as dependency, mental and physical decline at around 2.5 years follow up was explored by multivariable and time-to-event analyses.

Results: Mortality was predicted independently from age, sex and comorbidities only by the frail status of the Fried model in those over 75 years old [HR (95 % CI) = 2.50 (1.20-5.20)]. Mental decline was independently predicted only by pre-frail [OR (95 % CI) = 0.24 (0.10-0.55)] and frail [OR (95 % CI) = 0.196 (0.06-0.67)] status of Fried model in those 65-75 years old. The prediction of dependency and physical decline by pre-frail and frail status of any the three frailty models was not statistically significant in this cohort of older adults.

Conclusions: None of the three frailty models was valid at predicting 5 years mortality and disability, mental and physical decline at 2.5 years in a cohort of older adults in north-west Russia. Frailty by the Fried model had only limited value for mortality in those 75 years old and mental decline in those 65-75 years old. Further research is needed to identify valid frailty markers for older adults in this population.

No MeSH data available.


Related in: MedlinePlus