Frailty and its related Factors in Vulnerable Elderly Population by Age Groups

Eunok Park; Mi Yu

doi:10.4040/jkan.2016.46.6.848

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Park and Yu: Frailty and its related Factors in Vulnerable Elderly Population by Age Groups

Original Article

J Korean Acad Nurs 2016;46(6):848-857.

Published online: 15 December 2016

DOI: https://doi.org/10.4040/jkan.2016.46.6.848

Frailty and its related Factors in Vulnerable Elderly Population by Age Groups

Eunok Park¹, Mi Yu^2,

¹College of Nursing, Jeju National University, Jeju

²College 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

Received 6 June 2016 Revised 8 September 2016 Accepted 29 September 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.

Keywords: Frail Elderly, Depression, Cognition, Age Group

References

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Table 1.

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		2.21^a±3.02	3.30^b±3.55	5.08^c±4.44	692.78	＜.001
Depression	0~15		4.24^a±2.11	4.57^b±2.27	4.84^c±2.37	90.41	＜.001
Cognitive condition	0~30		22.55^a±4.67	20.82^b±4.81	18.78^c±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.

Table 2.

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.

Table 3.

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)

Table 4.

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.

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