Impairments in mobility and balance in relation to frailty

Abstract

We set out to describe the relationship between impaired balance, mobility and frailty, and relate these to risk of death. We examined a subsample of 1295 community-dwelling non-demented adults from the second wave of the Canadian Study of Health and Aging (CSHA), a prospective population-based cohort study. Frailty index (FI) scores were constructed from a standardized comprehensive geriatric assessment (FI-CGA). History of mobility impairments and falls were assessed. Timed-up-and-go (TUG) and functional reach (FR) performance were measured. The CSHA clinical frailty scale (CFS) was judged by a physician. Adverse outcomes were determined at CSHA-3, conducted 5 years later. The FI-CGA varied in association with impaired mobility and balance. A history of mobility problems was demonstrable at FI-CGA scores >0.12. This level of frailty also represented the most marked deterioration in performance measures (TUG and FR). FI-CGA scores best predicted mortality (HR 1.04±0.02), proving to be a dominating factor in multivariate regression models that included mobility and balance markers. Only at the upper range of FI-CGA reported (>0.45) did all participants demonstrate mobility impairment. Impaired balance and mobility contribute to frailty, but neither is sufficient to define a participant as frail.