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. 2017 Aug 30;17(1):196.
doi: 10.1186/s12877-017-0595-0.

A four-domain approach of frailty explored in the Doetinchem Cohort Study

Sandra H van Oostrom  1 , Daphne L van der A  2 , M Liset Rietman  2   3 , H Susan J Picavet  2 , Manon Lette  2 , W M Monique Verschuren  2   3 , Simone R de Bruin  2 , Annemieke M W Spijkerman  2
Affiliations

A four-domain approach of frailty explored in the Doetinchem Cohort Study

Sandra H van Oostrom et al. BMC Geriatr. .

Abstract

Background: Accumulation of problems in physical, psychological, cognitive, or social functioning is characteristic for frail individuals. Using a four-domain approach of frailty, this study explored how sociodemographic and lifestyle factors, life events and health are associated with frailty.

Methods: The study sample included 4019 men and women (aged 40-81 years) examined during the fifth round (2008-2012) of the Doetinchem Cohort Study. Four domains of frailty were considered: physical (≥4 of 8 criteria: unintentional weight loss, exhaustion, strength, perceived health, walking, balance, hearing and vision impairments), psychological (2 criteria: depressive symptoms, mental health), cognitive (<10th percentile on global cognitive functioning), and social frailty (≥2 of 3 criteria: loneliness, social support, social participation). Logistic regression was used to study the cross-sectional association of sociodemographic factors, lifestyle, life events and chronic diseases with frailty domains.

Results: About 17% of the population was frail on one or more domains. Overlap between the frailty domains was limited since 82% of the frail population was frail on one domain only. Low educated respondents were at higher risk of being psychologically and socially frail. Having multiple diseases was associated with a higher risk of being physically and psychologically frail. Being physically active was consistently associated with a lower risk of frailty on each of the four domains. Short or long sleep duration was associated with a higher risk of being physically, psychologically, and socially frail.

Conclusions: Sociodemographic factors, lifestyle and multimorbidity contributed differently to the four frailty domains. It is important to consider multiple frailty domains since this helps to identify different groups of frail people, and as such to provide tailored care and support. Lifestyle factors including physical activity, smoking and sleep duration were associated with multiple domains of frailty.

Keywords: Frailty; Lifestyle; Multidimensional; Physical activity; Prospective cohort; Sleep.

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Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from all participants. The Medical Ethics Committees of the Netherlands Organization of Applied Scientific Research and the University of Utrecht approved the study.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Adapted version of the integral conceptual model of frailty, based on Gobbens [19]
See this image and copyright information in PMC

References

    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Series A, Biol Sci Med Sci. 2001;56(3):M146–M156. doi: 10.1093/gerona/56.3.M146. - DOI - PubMed
    1. Hogan DB, MacKnight C, Bergman H. Steering committee Canadian initiative on frailty and aging: models, definitions, and criteria of frailty. Aging Clin Exp Res. 2003;15(3 Suppl):1–29. - PubMed
    1. Levers MJ, Estabrooks CA, Ross Kerr JC. Factors contributing to frailty: literature review. J Adv Nurs. 2006;56(3):282–291. doi: 10.1111/j.1365-2648.2006.04021.x. - DOI - PubMed
    1. Markle-Reid M, Browne G. Conceptualizations of frailty in relation to older adults. J Adv Nurs. 2003;44(1):58–68. doi: 10.1046/j.1365-2648.2003.02767.x. - DOI - PubMed
    1. Gobbens RJ, Luijkx KG, Wijnen-Sponselee MT, Schols JM. Toward a conceptual definition of frail community dwelling older people. Nurs Outlook. 2010;58(2):76–86. doi: 10.1016/j.outlook.2009.09.005. - DOI - PubMed

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