ABSTRACT
BACKGROUND: Frail elderly have a higher risk of adverse outcomes, e.g., hospitalization,institutionalization, or premature death. The Tilburg Frailty Indicator (TFI) is a validated questionnaire for measuring frailty in independently living older people aged 70 years and over. AIMS: Determining the prevalence of frailty among independently living young elderly, and examining which factors predict frailty among this target group. METHODS: 308 young elderly (58 to 64 years) completed the TFI before they visited the ambulatory health screening centre in Roosendaal. The TFI includes questions concerning physical, psychological and social frailty, and questions on possible determinants of frailty. RESULTS: 18-4% of the sample of young elderly was frail. Women scored significantly higher on psychological and social frailty. The determinants explained 37% of the frailty score. As expected,low income, an unhealthy lifestyle, multimorbidity, experiencing life events, and dissatisfaction with the living environment predicted frailty. The three frailty domains(physical, psychological, social) were affected by different determinants. CONCLUSION: A substantial part of the young elderly in the sample turned out to be frail. The finding that the three domains of frailty are predicted by different determinants underlines the importance the importance of a broad perspective regarding the functioning of the individual older person.
Subject(s)
Frail Elderly/psychology , Frail Elderly/statistics & numerical data , Health Status , Quality of Life/psychology , Age Factors , Aged , Comorbidity , Disability Evaluation , Female , Geriatric Assessment/methods , Geriatric Assessment/statistics & numerical data , Humans , Male , Middle Aged , Netherlands , Risk Factors , Socioeconomic Factors , Surveys and Questionnaires , Vulnerable PopulationsABSTRACT
OBJECTIVES: Most conceptual and operational definitions of frailty place heavy emphasis on the physical problems encountered by older people. The accompanying models are based largely on a medical model. An integral approach is almost never adopted. This study aims to develop both an integral operational definition of frailty and an integral conceptual model of frailty. DESIGN: In order to achieve these aims, a thorough literature search was performed on components of operational definitions and models of frailty. In addition, experts (N=17) were consulted during two expert meetings. RESULTS: There was consensus among the experts on the inclusion of the following components in the operational definition of frailty: strength, balance, nutrition, endurance, mobility, physical activity and cognition. Some respondents indicated that they would wish to add components from the psychological or social domain. Supported by results from the literature search, a new integral operational definition of frailty was developed. This operational definition lies at the heart of an integral conceptual working model of frailty. This model expresses the relationships between three domains of frailty, adverse outcomes such as disability and the determinants. CONCLUSION: The model should be able to serve as a basis for further scientific research on frailty. The model also provides a framework for the development of a measurement instrument which can be used for the identification of frail elderly persons.