Prevalence of frailty and its correlation with chronic non-infectious diseases among outpatients in Moscow

The aim of this study was to research the prevalence of frailty and prefrailty and their relationship with chronic non-infectious diseases among outpatients in Moscow.

Methods. The study included 356 patients ≥65 years (mean age 74.9 ± 6.1), 80.4% (n = 286) were women. For identify frailty, the phenotype model and the deficit accumulation model were used. The chronic non-infectious diseases was detected by an anamnesis and evaluating medical records.

Results. Frailty and prefrailty according to the criteria of the phenotypic model were identified in 8.9% and 61.3% cases; according to the criteria of the deficit accumulation model – in 4.2% and 45.8% cases, resp. The average number of chronic non-infectious diseases was significantly higher in patients with frailty both  – by the phenotype model (4.0 ± 1.3 vs 2.8 ± 1.4) and by the deficit accumulation model (5.8 ± 0.9 vs 2.5 ± 1.2). Taking into account the influence of age, the risk of prefrailty according to the phenotypic model increases 2.7 times in the presence of chronic heart failure; according to the deficit accumulation model – 5.6 times in the presence of coronary heart disease, 4.2 times with in the joint diseases, 3.7 times with diabetes and 3 times with cancer.

Conclusion. А high prevalence of prefrailty among outpatients in Moscow 65 years and older, as well as a reliable relationship between frailty and prefrailty with the total number and individual chronic non-infectious diseases were revealed. It is important to take measures to prevent the development and progression of frailty among outpatients, having a potentially high prevalence of chronic non-infectious diseases.

1. Clegg A. Frailty in elderly people. Lancet. 2013; 381(9868): 752–762.

2. Collard R.M. Prevalence of frailty in community dwelling older persons: a systematic review. J. Am. Geriatr. Soc. 2012; 60(8): 1487–1492.

3. Gurina N.A., Frolova E.V., Degryse J.M. A roadmap of aging in Russia: the prevalence of frailty in community-dwelling older adults in the St. Petersburg district–the «Crystal» study. J. Amer. Geriatr. Soc. 2011; 59 (6): 980–988.

4. Tkacheva O.N. et al. Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging. 2018, 9, 13: 251–259. doi: 10.2147/CIA.S153389.

5. Fried L.P. Frailty in older adults: evidence for a phenotype. J. Gerontol. Med. Sci. 2001; 56 (3): 146–156.

6. Kulminski A.M. Cumulative Deficits Better Characterize Susceptibility to Death in the Elderly than Phenotypic Frailty: Lessons from the Cardiovascular Health Study. J. Am. Geriatr. Soc. 2008; 56(5): 898–903.

7. Кривецкий В.В. Клиническая эпидемиология основных гериатрических синдромов в неврологической и нейрохирургической практике. Научные ведомости Белгородского государственного университета. Серия: Медицина. Фармация. 2012; 22 (141). 127–131 с.

8. Drame M. Rapid cognitive decline, one-year institutional admission and one-year mortality: analysis of the ability to predict and inter-tool agreement of four validated clinical frailty indexes in the SAFEs cohort. J. Nutr. Health. Aging. 2011; 15(8): 699–705.

9. Afilalo J. Frailty in patients with cardiovascular disease: Why, when, and how to measure. Curr. Cardiovasc. Risk Rep. 2011; 5: 467–472.

10. Castrejon-Perez R.C. Diabetes mellitus, hypertension and frailty: A population-based, cross-sectional study of Mexican older adults. Geriatr. Gerontol. Int. 2016; 17(6): 849–859.

11. Galizia G. Role of clinical frailty on long-term mortality of elderly subjects with and without chronic obstructive pulmonary disease. Aging Clin. Exp. Res. 2011; 23(2): 118–125.

12. Garcia-Esquinas E. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J. Am. Med. Dir. Assoc. 2015; 16(9): 748–754.

13. Handforth C. The prevalence and outcomes of frailty in older cancer patients: a systematic review. Ann. Oncol. 2015; 26(6): 1091–1101.

14. Veronese N. Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults: Results from a meta-analysis and exploratory meta-regression analysis. Ageing Res. Rev. 2017; 35: 63–73.

15. Зарудский А.А. Старческая астения и ее спутники как новая ветвь сердечно-сосудистого континуума. Клиническая геронтология. 2015; 21: 49–53.

16. Ларина В.Н. Риск развития сердечно-сосудистых осложнений и гериатрические синдромы у женщин пожилого и старческого возраста. 2017; 57 (3): 58–64.

17. Weiss O.C. Frailty and Chronic Diseases in Older Adults Clin. Geriatr. Med. 2011; 27: 39–52.