Introduction

Frailty, sarcopenia and fragility fractures are powerful correlated and all of them are predictors of clinical adverse outcomes. Elderly individuals with have a fragility fracture should be assessed for frailty and sarcopenia to better develop a care plan. For these reason interventions are necessary to determinate and treat frailty.

Objectives

The present study investigates the prevalence of frailty and associated factors among the older adults who were assessed within the scope of a geriatric study in the Fatih District of the Istanbul Province.

Methods

The study included community-dwelling older adults aged 61-101 years who were living in the Fatih District of the Istanbul Province between November 2014 and May 2015. The number of drugs regularly used by the participants and the number of diseases were recorded. It was evaluated whether the participants experienced falling / risk of falling / fear of falling in the last 1 year. Visual analog scale (VAS) was used in the assessment of chronic pain. The other instruments used for assessment included the FRAIL scale for frailty screening; the 6-item KATZ Activities of Daily Living (ADL) scale; the 8-item LAWTON-BRODY Instrumental Activities of Daily Living Scale (IADL) for the measurement of functional capacity; the European Quality 5 Dimensions (EQ-5D) questionnaire for the assessment of quality of life; the Mini-Cog test for cognitive screening; the Geriatric Depression Scale-Short Form (GDS-SF) for depression screening; the Mini Malnutrition Assessment-Short Form (MNA-SF) for malnutrition screening; and the Romberg test and postural instability test for walking. Hand grip strength (HGS) was measured using a Jamar hydraulic hand dynamometer and the thresholds for hand grip strength were evaluated < 27 kg < 16 kg in men and women, respectively, based on the European Working Group on Sarcopenia in Older People (EWGSOP2) definition. Muscle mass was measured through a bioimpedance analysis (TANITA-BC532). Low muscle mass (young adult mean-2SD) and the thresholds for muscle mass were evaluated as < 9.2 kg/m2 vs 7.4 kg/m2 in men and women, respectively, based on national data. Sarcopenia was defined as a reduction in muscle mass and muscle function [usual gait speed (UGS) or muscle strength] based on the European Working Group on Sarcopenia in Older People (EWGSOP2) definition.

Results

The study included 204 older adults (94 men and 110 women), with a mean age of 75.4±7.3 years. Of the cases, 30.4% were robust, 42.6% were pre-frail and 27% were frail. Significant differences were recorded in number of diseases (p=0.006), frail score (p=0.002), malnutrition (p=0.004) and the results of a clock-drawing test (CDT)(p=0.040), number of drugs, chronic pain(p=0.001), as well as in the fear of falling, IADL, GDS-SF, -EQ-5D scores, BIA fat, BIA muscle and hand grip strength (p< 0.001) between the groups. The frailty groups differed significantly in terms of the presence of malnutrition, fear of falling, urinary incontinence (UI), chronic pain, Romberg sign, postural instability, level of ambulation, presence of depression, dementia, falls within the last one year (p< 0.001) and gender (p=0.004). A regression analysis evaluating independent frailty-associated factors [dependent variable: frailty (robust vs. prefrail +frail)], revealed an association with the number of drugs (OR=1.24, p=0.036), cognitive disorder (OR=0.30, p=0.016) and EQ-5D (OR=1.53, p=0.017).

Conclusions

The present study established the prevalence of frailty in the Fatih district community, in which the most prominent associated factors were cognitive dysfunction, low quality of life, and multiple drug usage. Nationwide population studies involving multiple centers are required.

中文翻译：

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社区老年人样本中虚弱及其关联的影响

介绍

衰弱、肌肉减少症和脆性骨折具有很强的相关性，它们都是临床不良结果的预测因素。应评估患有脆性骨折的老年人的虚弱和肌肉减少症，以更好地制定护理计划。由于这些原因，干预对于确定和治疗虚弱是必要的。

目标

本研究调查了在伊斯坦布尔省法提赫区的一项老年病学研究范围内评估的老年人中虚弱的患病率和相关因素。

方法

该研究包括 2014 年 11 月至 2015 年 5 月期间居住在伊斯坦布尔省法提赫区的 61-101 岁的社区老年人。记录了参与者经常使用的药物数量和疾病数量。评估参与者在过去 1 年是否经历过跌倒/跌倒风险/害怕跌倒。视觉模拟量表 (VAS) 用于评估慢性疼痛。用于评估的其他工具包括用于体弱筛查的 FRAIL 量表；6 项 KATZ 日常生活活动 (ADL) 量表；用于测量功能能力的 8 项 LAWTON-BRODY 日常生活工具活动量表 (IADL)；用于评估生活质量的欧洲质量 5 维度 (EQ-5D) 问卷；用于认知筛查的 Mini-Cog 测试；用于抑郁症筛查的老年抑郁量表 - 简表 (GDS-SF)；用于营养不良筛查的小型营养不良评估简表 (MNA-SF)；以及行走的 Romberg 测试和姿势不稳定性测试。根据欧洲老年人肌肉减少症工作组 (EWGSOP2)，使用 Jamar 液压手测力计测量手握力 (HGS)，并分别评估男性和女性的手握力阈值 < 27 kg < 16 kg定义。通过生物阻抗分析 (TANITA-BC532) 测量肌肉质量。根据国家数据，男性和女性的肌肉质量低（年轻人平均为 2SD）和肌肉质量阈值分别为 < 9.2 kg/m2 和 7.4 kg/m2。

结果

该研究包括 204 名老年人（94 名男性和 110 名女性），平均年龄为 75.4±7.3 岁。在这些病例中，30.4% 是健壮的，42.6% 是体弱的，27% 是虚弱的。在疾病数量 (p=0.006)、体弱评分 (p=0.002)、营养不良 (p=0.004) 和时钟绘图测试 (CDT) (p=0.040) 的结果、药物数量、慢性疼痛（p=0.001），以及在跌倒的恐惧中，IADL、GDS-SF、-EQ-5D 评分、BIA 脂肪、BIA 肌肉和手握力（p<0.001）。虚弱组在营养不良、跌倒恐惧、尿失禁 (UI)、慢性疼痛、Romberg 征、姿势不稳、行走水平、抑郁症、痴呆、最近一年内跌倒方面存在显着差异（p < 0.001) 和性别 (p=0.004)。

结论

本研究确定了法提赫地区社区的虚弱患病率，其中最突出的相关因素是认知功能障碍、生活质量低和多种药物使用。需要涉及多个中心的全国性人口研究。