Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country
BackgroundFrailty has been increasingly recognized as a public health problem for aging populations with significant social impact, particularly in low- and middle-income countries. We aimed to develop a modified version of the Thai Frailty Index (TFI) and explore the association between different f...
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| Format: | Article |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1060990/full |
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| author | Ekkaphop Morkphrom Ekkaphop Morkphrom Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Unchana Sura-amonrattana Unchana Sura-amonrattana Arunotai Siriussawakul Arunotai Siriussawakul Arunotai Siriussawakul Supawadee Sainimnuan Supawadee Sainimnuan Rinrada Preedachitkun Wichai Aekplakorn |
| author_facet | Ekkaphop Morkphrom Ekkaphop Morkphrom Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Unchana Sura-amonrattana Unchana Sura-amonrattana Arunotai Siriussawakul Arunotai Siriussawakul Arunotai Siriussawakul Supawadee Sainimnuan Supawadee Sainimnuan Rinrada Preedachitkun Wichai Aekplakorn |
| author_sort | Ekkaphop Morkphrom |
| collection | DOAJ |
| description | BackgroundFrailty has been increasingly recognized as a public health problem for aging populations with significant social impact, particularly in low- and middle-income countries. We aimed to develop a modified version of the Thai Frailty Index (TFI) and explore the association between different frailty statuses, socioeconomic factors, and mortality in community-dwelling older people from a middle-income country.MethodsThe data from participants aged ≥60 years in the Fourth Thai National Health Examination Survey were used to construct the 30-item TFI. Cutoff points were created based on stratum-specific likelihood ratio. TFI ≤ 0.10 was categorized as fit, 0.10–0.25 as pre-frail, 0.25–0.45 as mildly frail, and >0.45 as severely frail. The association of frailty status with mortality was examined using Cox proportional hazard models.FindingsAmong 8,195 older adults with a mean age of 69.2 years, 1,284 died during the 7-year follow-up. The prevalence of frailty was 16.6%. The adjusted hazard ratio (aHR) for mortality in pre-frail was 1.76 (95% CI = 1.50–2.07), mildly frail 2.79 (95% CI = 2.33–3.35), and severely frail 6.34 (95% CI = 4.60–8.73). Having a caretaker in the same household alleviated mortality risk for severely frail participants with an aHR of 2.93 (95% CI = 1.92–4.46) compared with an aHR of 6.89 (95% CI = 3.87–12.26) among those living without a caretaker.InterpretationThe severity of frailty classified by the modified TFI can predict long-term mortality risk for community-dwelling older adults. Identification of severely frail older people to provide appropriate care might alleviate mortality risk. Our findings can inform policymakers to appropriately allocate services in a resource-limited setting. |
| first_indexed | 2024-03-12T11:40:47Z |
| format | Article |
| id | doaj.art-a839dde5170c4f7e852cc95f56ad4891 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T11:40:47Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-a839dde5170c4f7e852cc95f56ad48912023-08-31T16:16:14ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-12-01910.3389/fmed.2022.10609901060990Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income countryEkkaphop Morkphrom0Ekkaphop Morkphrom1Varalak Srinonprasert2Varalak Srinonprasert3Varalak Srinonprasert4Varalak Srinonprasert5Unchana Sura-amonrattana6Unchana Sura-amonrattana7Arunotai Siriussawakul8Arunotai Siriussawakul9Arunotai Siriussawakul10Supawadee Sainimnuan11Supawadee Sainimnuan12Rinrada Preedachitkun13Wichai Aekplakorn14Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Geriatric Internal Medicine Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Geriatric Internal Medicine Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandIntegrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Geriatric Internal Medicine Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandIntegrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Geriatric Internal Medicine Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandSiriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackgroundFrailty has been increasingly recognized as a public health problem for aging populations with significant social impact, particularly in low- and middle-income countries. We aimed to develop a modified version of the Thai Frailty Index (TFI) and explore the association between different frailty statuses, socioeconomic factors, and mortality in community-dwelling older people from a middle-income country.MethodsThe data from participants aged ≥60 years in the Fourth Thai National Health Examination Survey were used to construct the 30-item TFI. Cutoff points were created based on stratum-specific likelihood ratio. TFI ≤ 0.10 was categorized as fit, 0.10–0.25 as pre-frail, 0.25–0.45 as mildly frail, and >0.45 as severely frail. The association of frailty status with mortality was examined using Cox proportional hazard models.FindingsAmong 8,195 older adults with a mean age of 69.2 years, 1,284 died during the 7-year follow-up. The prevalence of frailty was 16.6%. The adjusted hazard ratio (aHR) for mortality in pre-frail was 1.76 (95% CI = 1.50–2.07), mildly frail 2.79 (95% CI = 2.33–3.35), and severely frail 6.34 (95% CI = 4.60–8.73). Having a caretaker in the same household alleviated mortality risk for severely frail participants with an aHR of 2.93 (95% CI = 1.92–4.46) compared with an aHR of 6.89 (95% CI = 3.87–12.26) among those living without a caretaker.InterpretationThe severity of frailty classified by the modified TFI can predict long-term mortality risk for community-dwelling older adults. Identification of severely frail older people to provide appropriate care might alleviate mortality risk. Our findings can inform policymakers to appropriately allocate services in a resource-limited setting.https://www.frontiersin.org/articles/10.3389/fmed.2022.1060990/fullfrailtyoldermortality riskThailandcaretaker |
| spellingShingle | Ekkaphop Morkphrom Ekkaphop Morkphrom Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Varalak Srinonprasert Unchana Sura-amonrattana Unchana Sura-amonrattana Arunotai Siriussawakul Arunotai Siriussawakul Arunotai Siriussawakul Supawadee Sainimnuan Supawadee Sainimnuan Rinrada Preedachitkun Wichai Aekplakorn Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country Frontiers in Medicine frailty older mortality risk Thailand caretaker |
| title | Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country |
| title_full | Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country |
| title_fullStr | Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country |
| title_full_unstemmed | Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country |
| title_short | Severity of frailty using modified Thai frailty index, social factors, and prediction of mortality among community-dwelling older adults in a middle-income country |
| title_sort | severity of frailty using modified thai frailty index social factors and prediction of mortality among community dwelling older adults in a middle income country |
| topic | frailty older mortality risk Thailand caretaker |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1060990/full |
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