Potentially modifiable risk factors of frailty in community-dwelling older fallers

Background and Aim: Falls in the older adult are associated with significant morbidity, functional decline and institutionalization. As the population ages, falls are likely to increase in incidence. Thus, prevention is a key public health objective. Frailty, given its association with increased fa...

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Main Author: Toh, Wen Shien
Other Authors: Laura Tay
Format: Final Year Project (FYP)
Language:English
Published: 2017
Subjects:
Online Access:http://hdl.handle.net/10356/72644
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author Toh, Wen Shien
author2 Laura Tay
author_facet Laura Tay
Toh, Wen Shien
author_sort Toh, Wen Shien
collection NTU
description Background and Aim: Falls in the older adult are associated with significant morbidity, functional decline and institutionalization. As the population ages, falls are likely to increase in incidence. Thus, prevention is a key public health objective. Frailty, given its association with increased fall risk, could be an entity to be screened for and targeted. The aim of this study is to characterize the differences between frail and non-frail fallers, and thus identify potentially modifiable risk factors. It is hypothesized that differences in falls profile, physical, psychiatric, functional, nutritional indicators and co-morbidities would exist. Methods: A cross-sectional analysis of 58 community-dwelling older fallers was performed. They were screened for pre-frailty or frailty using the FRAIL questionnaire, then classified via objective assessment into frail and non-frail based on an adaptation of Fried’s frailty criteria. Subjects’ baseline characteristics were evaluated, including falls history, physical performance and endurance tests, scoring of cognition and mood, questionnaires to assess function, laboratory investigations for nutrition and review of co-morbidities. Results: 70.7% of fallers were non-frail, while 29.3% were frail. Both groups did not significantly differ in terms of age, gender and ethnicity. Cognitive impairment, determined by a lower Chinese Mini-Mental State Examination (CMMSE) score, was associated with increased risk of physical frailty. Depressive symptoms, measured by the Geriatric Depression Scale (GDS) were also linked with frailty. Frail fallers had impaired physical performance and endurance, and more fall risk factors. When adjusted for age and gender, lower CMMSE scores (OR=0.864, p=0.045) remained independently associated with frailty. Frailty is not synonymous with functional decline or co-morbidity, as differences in these domains were not significant. Conclusion: Frailty predicts potentially modifiable risk factors in the physical and psychiatric domain. Thus, it is a syndrome that should be screened for and targeted as part of a holistic falls prevention programme.
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spelling ntu-10356/726442020-11-01T05:33:34Z Potentially modifiable risk factors of frailty in community-dwelling older fallers Toh, Wen Shien Laura Tay Lee Kong Chian School of Medicine (LKCMedicine) DRNTU::Science::Medicine Background and Aim: Falls in the older adult are associated with significant morbidity, functional decline and institutionalization. As the population ages, falls are likely to increase in incidence. Thus, prevention is a key public health objective. Frailty, given its association with increased fall risk, could be an entity to be screened for and targeted. The aim of this study is to characterize the differences between frail and non-frail fallers, and thus identify potentially modifiable risk factors. It is hypothesized that differences in falls profile, physical, psychiatric, functional, nutritional indicators and co-morbidities would exist. Methods: A cross-sectional analysis of 58 community-dwelling older fallers was performed. They were screened for pre-frailty or frailty using the FRAIL questionnaire, then classified via objective assessment into frail and non-frail based on an adaptation of Fried’s frailty criteria. Subjects’ baseline characteristics were evaluated, including falls history, physical performance and endurance tests, scoring of cognition and mood, questionnaires to assess function, laboratory investigations for nutrition and review of co-morbidities. Results: 70.7% of fallers were non-frail, while 29.3% were frail. Both groups did not significantly differ in terms of age, gender and ethnicity. Cognitive impairment, determined by a lower Chinese Mini-Mental State Examination (CMMSE) score, was associated with increased risk of physical frailty. Depressive symptoms, measured by the Geriatric Depression Scale (GDS) were also linked with frailty. Frail fallers had impaired physical performance and endurance, and more fall risk factors. When adjusted for age and gender, lower CMMSE scores (OR=0.864, p=0.045) remained independently associated with frailty. Frailty is not synonymous with functional decline or co-morbidity, as differences in these domains were not significant. Conclusion: Frailty predicts potentially modifiable risk factors in the physical and psychiatric domain. Thus, it is a syndrome that should be screened for and targeted as part of a holistic falls prevention programme. Bachelor of Medicine and Bachelor of Surgery 2017-09-04T00:57:53Z 2017-09-04T00:57:53Z 2017 Final Year Project (FYP) http://hdl.handle.net/10356/72644 en 8 p. application/pdf
spellingShingle DRNTU::Science::Medicine
Toh, Wen Shien
Potentially modifiable risk factors of frailty in community-dwelling older fallers
title Potentially modifiable risk factors of frailty in community-dwelling older fallers
title_full Potentially modifiable risk factors of frailty in community-dwelling older fallers
title_fullStr Potentially modifiable risk factors of frailty in community-dwelling older fallers
title_full_unstemmed Potentially modifiable risk factors of frailty in community-dwelling older fallers
title_short Potentially modifiable risk factors of frailty in community-dwelling older fallers
title_sort potentially modifiable risk factors of frailty in community dwelling older fallers
topic DRNTU::Science::Medicine
url http://hdl.handle.net/10356/72644
work_keys_str_mv AT tohwenshien potentiallymodifiableriskfactorsoffrailtyincommunitydwellingolderfallers