Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014;18(6):622-7.
doi: 10.1007/s12603-014-0033-3.

Age, frailty, disability, institutionalization, multimorbidity or comorbidity. Which are the main targets in older adults?

P Abizanda  1 , L Romero, P M Sánchez-Jurado, M Martínez-Reig, S A Alfonso-Silguero, L Rodríguez-Mañas
Affiliations

Age, frailty, disability, institutionalization, multimorbidity or comorbidity. Which are the main targets in older adults?

P Abizanda et al. J Nutr Health Aging. 2014.

Abstract

Objectives: Age, frailty, disability, institutionalization, multimorbidity or comorbidity are main risk factors for serious health adverse outcomes in older adults. However, the adjusted relevance of each of them in order to determine which characteristics must be of importance for health policies in this population group, has not been established.

Design: Concurrent population-based cohort study.

Setting: Albacete city, Spain.

Participants: 842 participants over age 70 from the FRADEA Study.

Measurements: Age, gender, institutionalization, frailty (Fried's criteria), previous disability in basic activities of daily living (BADL) (Barthel index), comorbidity (Charlson index), and multimorbidity (≥ 2 from 14 selected diseases) were recorded in the basal visit. The combined event of mortality or incident disability in BADL was determined in the follow-up visit. The risk of presenting adverse events was determined by Kaplan-Meier analysis and logistic regression adjusted for age, sex, and institutionalization.

Results: Mean follow-up 520 days. 63 participants died (7.5%). Among the remaining 779, 191 lost at least one BADL (24.5%). The combined event of mortality or disability was present in 254 participants (30.2%). Age (OR 1.10, 95%CI 1.06-1.14), frailty (OR 3.07, 95%CI 1.63-5.77), disability (OR 2.19, 95%CI 1.43-3.36) and institutionalization (OR 2.73, 95%CI 1.68-4.44) were independently associated with the combined adverse event, but not comorbidity or multimorbidity. In subjects younger than 80, only frailty, disability and institutionalization were risk factors, and in those aged ≥ 80, only age, disability and institutionalization were.

Conclusions: Health policies for older adults must take into account mainly frailty and disability in subjects younger than 80 and disability in those older than 80.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Combined event analysis depending on frailty status (panel A), disability in BADL (panel B), high comorbidity (panel C), or multimorbidity (panel D). Kaplan-Meier analysis
See this image and copyright information in PMC

References

    1. American Geriatrics Society Core Writing Group of the Task Force on the Future of Geriatric Medicine. Caring for older Americans: The future of Geriatric Medicine. J Am Geriatr Soc. 2005;53:S245–S256. 10.1111/j.1532-5415.2005.53350.x - DOI - PubMed
    1. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: Towards a more uniform methodology. Ann Fam Med. 2012;10:142–151. 10.1370/afm.1337 PubMed PMCID 3315131; PMID 22412006. - DOI - PMC - PubMed
    1. Glynn LG, Valderas JM, Healy P, et al. The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Family Practice. 2011;28:516–523. 10.1093/fampra/cmr013 PubMed PMID: 21436204. - DOI - PubMed
    1. Smith SM, Soubhi H, Fortin M, Hudon C, O'Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. BMJ. 2012;345:e5205. 10.1136/bmj.e5205 PubMed PMCID 3432635; PMID 22945950. - DOI - PMC - PubMed
    1. American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Patient-centered care for older adults with multiple chronic conditions: A stepwise approach from the American Geriatrics Society. J Am Geriatr Soc. 2012;60:1957–1968. 10.1111/j.1532-5415.2012.04187.x - DOI - PMC - PubMed

Uncited references

    1. Fried LP, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults: the Cardiovascular Health Study. JAMA. 1998;279:585–592. 10.1001/jama.279.8.585 PubMed PMID: 9486752. - DOI - PubMed
    1. Weiss CO. Frailty and chronic diseases in older adults. Clin Geriatr Med. 2011;27:39–52. 10.1016/j.cger.2010.08.003 PubMed PMID: 21093721. - DOI - PubMed

Publication types