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. 2018 Apr 4;18(1):84.
doi: 10.1186/s12877-018-0776-5.

The frail older person does not exist: development of frailty profiles with latent class analysis

W M Looman  1 , I N Fabbricotti  2 , J W Blom  3 , A P D Jansen  4 , J E Lutomski  5 , S F Metzelthin  6 , R Huijsman  2 ; TOPICS-MDS Research Consortium
Affiliations

The frail older person does not exist: development of frailty profiles with latent class analysis

W M Looman et al. BMC Geriatr. .

Abstract

Background: A fundamental issue in elderly care is targeting those older people at risk and in need of care interventions. Frailty is widely used to capture variations in health risks but there is no general consensus on the conceptualization of frailty. Indeed, there is considerable heterogeneity in the group of older people characterized as frail. This research identifies frailty profiles based on the physical, psychological, social and cognitive domains of functioning and the severity of the problems within these domains.

Methods: This research was a secondary data-analysis of older persons derived from The Older Person and Informal Caregiver Minimum Dataset. Selected respondents were 60 years and older (n = 43,704; 59.6% female). The following variables were included: self-reported health, cognitive functioning, social functioning, mental health, morbidity status, and functional limitations. Using latent class analysis, the population was divided in subpopulations that were subsequently discussed in a focus group with older people for further validation.

Results: We distinguished six frailty profiles: relatively healthy; mild physically frail; psychologically frail; severe physically frail; medically frail and multi-frail. The relatively healthy had limited problems across all domains. In three profiles older people mostly had singular problems in either the physical or psychological domain and the severity of the problems differed. Two remaining profiles were multidimensional with a combination of problems that extended to the social and cognitive domains.

Conclusions: Our research provides an empirical base for meaningful frailty profiles. The profiles showed specific patterns underlying the problems in different domains of functioning. The heterogeneous population of frail older people has differing needs and faces different health issues that should be considered to tailor care interventions. Evaluation research of these interventions should acknowledge the heterogeneity of frailty by profiling.

Keywords: Frailty; Latent class analysis; Older people; Profiles.

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Conflict of interest statement

Ethics approval and consent to participate

Studies using TOPICS-MDS fall outside the remit of the Medical Research Involving Human Subjects Act (WMO) on behalf of the research ethics committee of the Radboud University Medical Center. Therefore, such studies may be carried out in the Netherlands without additional approval by an accredited research ethics committee (http://topics-mds.eu/data-requests/695-2/). The TOPICS-MDS data were anonymized before its use. Before the start of the focus group, the aim of the focus group was clarified to the participants and oral consent was obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

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

References

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