JKAN Journal of Korean Academy of Nursing J Korean Acad Nurs 2005-3673 2093-758X Korean Society of Nursing Science 10.4040/jkan.2016.46.6.848 jkan-46-848 Original Article Frailty and its related Factors in Vulnerable Elderly Population by Age Groups ParkEunok1 YuMi2 College of Nursing, Jeju National University, Jeju College of Nursing·Institute of Health Sciences, Gyeongsang National University, Jinju, Korea Address reprint requests to : Yu, Mi College of Nursing, Gyeongsang National University, 816 beongil-15, Jinju-daero, Jinju, Gyeongnam 52727, Korea Tel: +82-55-772-8229 Fax: +82-55-772-8222 E-mail: yumi825@gnu.ac.kr 122016 15122016 466 848857 060620160809201629092016 Copyright © 2016 Korean Society of Nursing Science 2016 This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium Abstract Purpose

This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea.

 Methods

In this secondary analysis, data were collected from records for 22,868 elders registered in the Visiting Health Management program of Public Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group.

 Results

Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p<.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p<.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p<.001).

 Conclusion

The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.

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Differences in Variables by Age Group (N=22,868)

Characteristics Categories n 65~74 yr (n=9,032) 75~84 yr (n=11,530) Over 85 yr (n=2,306) χ2 p
n (%) n (%) n (%)
Gender Male 4,809 1,987 (22.0) 2,380 (20.6) 442 (19.2) 10.98 .004
　 Female 18,059 7,045 (78.0) 9,150 (79.4) 1,864 (80.8) 　 　
Smoking　 No 21,132 8,325 (92.8) 10,665 (93.2) 2,142 (93.7) 2.91 .233
Yes 1,573 649 (7.2) 780 (6.8) 144 (6.3) 　 　
Alcohol consumption　 No Yes 18,714 4,154 7,179 1,853 (79.5) (20.5) 9,536 1,994 (82.7) (17.3) 1,999 307 (86.7) (13.3) 75.98 　 ＜.001 　
Physical activity No Yes 21,889 979 8,545 487 (94.6) (5.4) 11,084 446 (96.1) (3.9) 2,260 46 (98.0) (2.0) 61.41 　 ＜.001 　
Skipping breakfast No 22,664 8,947 (99.1) 11,429 (99.1) 2,288 (99.2) 0.60 .740
Yes 204 85 (0.9) 101 (0.9) 18 (0.8) 　 　
No. of diseases None 1~2 2,110 17,559 980 6,827 (10.9) (75.6) 937 8,871 (8.1) (76.9) 193 1,861 (8.4) (80.7) 73.09 　 ＜.001 　
≥3 3,199 1,225 (13.6) 1,722 (14.9) 252 (10.9) 　 　
Hypertension No Yes 8,684 14,184 3,724 5,308 (41.2) (58.8) 4,129 7,401 (35.8) (64.2) 831 1,475 (36.0) (64.0) 67.26 　 ＜.001 　
Diabetes mellitus No 18,395 7,053 (78.1) 9,317 (80.8) 2,025 (87.8) 112.41 ＜.001
Yes 4,473 1,979 (21.9) 2,213 (19.2) 281 (12.2) 　 　
CVA No Yes 21,457 1,411 8,460 572 (93.7) (6.3) 10,783 747 (93.5) (6.5) 2,214 92 (96.0) (4.0) 21.25 　 ＜.001 　
Arthritis　 No Yes 7,810 15,058 3,477 5,555 (38.5) (61.5) 3,687 7,843 (32.0) (68.0) 646 1,660 (28.0) (72.0) 138.68 　 ＜.001 　
Urinary incontinence No 22,344 8,845 (97.9) 11,246 (97.5) 2,253 (97.7) 3.49 .175
Yes 524 187 (2.1) 284 (2.5) 53 (2.3) 　 　
Depression No 13,339 5,651 (62.6) 6,469 (56.1) 1,219 (52.9) 141.89 ＜.001
Mild 8,765 3,156 (34.9) 4,642 (40.3) 967 (41.9)
Severe 764 225 (2.5) 419 (3.6) 120 (5.2)
Cognitive condition Normal 18,534 7,866 (87.1) 9,159 (79.4) 1,509 (65.4) 600.00 ＜.001
Dementia 4,334 1,166 (12.9) 2,371 (20.6) 797 (34.6)
Frailty Not frail 18,765 8,104 (89.7) 9,222 (80.0) 1,439 (62.4) 999.50 ＜.001
Frail 4,103 928 (10.3) 2,308 (20.0) 867 (37.6)
Variables Range M±SD M±SD M±SD F p
Frailty 0~20 2.21a±3.02 3.30b±3.55 5.08c±4.44 692.78 ＜.001
Depression 0~15 4.24a±2.11 4.57b±2.27 4.84c±2.37 90.41 ＜.001
Cognitive condition 0~30 22.55a±4.67 20.82b±4.81 18.78c±5.14 684.41 ＜.001

a, b, c: post-hoc (Scheffé) comparison results for ANOVA. Different letters present that mean difference is significant with other groups.

Frailty by Age Group

Characteristics Categories 65~74 yr (n=9,032) 75~84 yr (n=11,530) Over 85 yr (n=2,306)
M ±SD t p M ±SD t p M ±SD t p
Smoking No 2.24 ±3.04 2.98 .003 3.29 ±3.55 -0.07 .945 5.09 ±4.43 -0.22 .829
Yes 1.90 ±2.75 3.30 ±3.45 5.17 ±4.68
Alcohol No 2.33 ±3.15 8.10 ＜.001 3.39 ±3.63 6.87 ＜.001 5.20 ±4.49 3.55 ＜.001
consumption　 Yes 1.78 ±2.42 2.85 ±3.09 4.32 ±3.99
Physical activity No 2.26 ±3.03 6.39 ＜.001 3.36 ±3.55 9.68 ＜.001 5.13 ±4.45 5.86 ＜.001
Yes 1.43 ±2.78 1.85 ±3.22 2.63 ±2.82
Skipping breakfast No 2.22 ±3.02 2.07 .041 3.29 ±3.55 -1.54 .127 5.07 ±4.42 -1.07 .301
Yes 1.67 ±2.42 3.94 ±4.22 6.67 ±6.34
Hypertension No 2.17 ±3.02 -1.12 .261 3.19 ±3.55 -2.55 .011 5.19 ±4.67 0.85 .398
Yes 2.24 ±3.02 3.36 ±3.55 5.02 ±4.31
Diabetes mellitus No 2.17 ±2.97 -2.57 .010 3.26 ±3.52 -2.11 .035 5.12 ±4.45 1.06 .288
Yes 2.37 ±3.18 3.45 ±3.70 4.82 ±4.39
CVA No 2.11 ±2.92 -9.57 ＜.001 3.20 ±3.48 -8.98 ＜.001 5.05 ±4.42 -1.68 .097
Yes 3.73 ±3.97 4.65 ±4.30 5.91 ±4.87
Arthritis No 1.85 ±3.06 -8.90 ＜.001 2.73 ±3.53 -11.91 ＜.001 4.51 ±4.46 -3.88 ＜.001
Yes 2.44 ±2.97 3.57 ±3.53 5.31 ±4.41
Urinary No 2.19 ±3.00 -4.10 ＜.001 3.27 ±3.53 -4.57 ＜.001 5.05 ±4.44 -2.28 .023
incontinence　 Yes 3.30 ±3.69 　 　 4.40 ±4.13 　 　 6.45 ±4.17 　 　

Frailty range; 0~20 score. CVA=Cerebrovascular accident.

Correlations among Variables

Variables 65~74 yr (n=9,032) 75~84 yr (n=11,530) Over 85 yr (n=2,306)
Frailty Depression Frailty Depression Frailty Depression
r (p) r (p) r (p) r (p) r (p) r (p)
Depression .26 (＜.001) 1 .28 (＜.001) 1 .26 (＜.001) 1
Cognitive condition -.23 (＜.001) -.14 (＜.001) -.29 (＜.001) -.16 (＜.001) -.41 (＜.001) -.25 (＜.001)

Factors Affecting Frailty of Elders by Age Group

Variables 65~74 yr 75~84 yr Over 85 yr
b SE ß t p b SE ß t p b SE ß t p
Intercept
Smoking* -0.22 0.12 .02 -1.86 .062
Alcohol consumption* -0.32 0.07 .04 -4.24 ＜.001 -0.22 0.08 .02 -2.73 .006 -0.37 0.25 .03 2.20 .138
Physical activity* -0.69 0.13 .05 -5.24 ＜.001 -1.26 0.16 .07 -8.05 ＜.001 -1.94 0.59 .06 10.66 .011
Skipping breakfast* -0.53 0.31 .02 -1.74 .082
No. of disease 0.22 0.08 .03 2.83 .005
Hypertension*
Diabetes mellitus* 0.19 0.07 .03 2.62 .009 0.15 0.09 .02 1.71 .087
CVA* 1.35 0.12 .11 10.94 ＜.001 1.11 0.13 .08 8.65 ＜.001 1.09 0.42 .05 6.57 .010
Arthritis* 0.48 0.06 .08 7.73 ＜.001 0.59 0.07 .08 8.26 ＜.001 0.40 0.19 .04 4.57 .033
Urinary incontinence* 0.72 0.21 .03 3.45 .001 0.59 0.20 .03 2.99 .003
Depression 0.31 0.01 .22 21.91 ＜.001 0.36 0.01 .23 26.56 ＜.001 0.30 0.04 .16 68.53 ＜.001
Cognitive condition -0.12 0.01 .19 -18.93 ＜.001 -0.18 0.01 .24 -27.4 ＜.001 -0.31 0.02 .36 349.39 ＜.001
F (p) 135.66 (＜.001) 245.40 (＜.001) 96.48 (＜.001)
R2 0.13 0.17 0.20

*Dummy variables (no=0, yes=1); Smoking, drinking alcohol, physical activity, skipping breakfast, hypertension, diabetes mellitus, cerebrovascular accidents, arthritis, urinary incontinence; CVA=C erebrovascular accide ents.