Frailty and Associated Risk Factors in Elderly People with Health Examination in Rural Areas of China

  • Jie GU Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China
  • Haiying CHEN Xidu Community Health Center of the Fengxian District, Shanghai 201400, P.R. China
  • Xiaoqing GU Xidu Community Health Center of the Fengxian District, Shanghai 201400, P.R. China
  • Xiaomin SUN Health Development Institute of Pudong, Shanghai 201208, P.R. China
  • Zhigang PAN Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China
  • Shanzhu ZHU Zhongshan Hospital of Fudan University, Shanghai 200032, P.R. China
  • Doris YOUNG Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
Keywords: Rural; Elderly people; Fried frailty phenotype definition; Frailty

Abstract

Abstract Background: Frailty is a common syndrome in elderly people, but has not been fully studied in China. We aimed to investigate the epidemiological characteristics of frailty and analyze its risk factors in elderly people in rural areas of China. Methods: This cross-sectional study was conducted between September and October 2016. Overall, 4323 elderly people over 60 yr were enrolled by cluster random sampling method from the Fengxian District of Shanghai, China. These subjects voluntarily participated in the health examination of the 2016 National Basic Public Health Service Program. In addition to regular examination items, frailty assessment was performed on the basis of Fried frailty phenotype criteria. Results: The prevalence of pre-frailty and frailty was 49.4% and 6.8%, respectively. Advanced age (OR=1.44 for pre-frailty and OR=2.01 for frailty, 65-74 years old; OR=3.02 for pre-frailty and OR=14.13 for frailty,75-84 years old; OR=8.17 for pre-frailty and OR=71.71 for frailty, ≥85 years old), female (OR=1.32 for pre-frailty and OR=1.97 for frailty), stroke history (OR=1.75 for pre-frailty and OR=2.43 for frailty), vision decrease (OR=1.98 for pre-frailty and OR=2.70 for frailty), and anemia (OR=1.95 for pre-frailty and OR=3.64 for frailty) were common risk factors for both pre-frailty and frailty. Conclusion: Healthy elderly people in the rural areas of Shanghai have relatively high prevalence of pre-frailty and frailty. Advanced age, female, stroke history, decreased vision, and anemia are the risk factors for pre-frailty and frailty.  

References

1. Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL (1994). Frailty in elderly people: an evolving concept. CMAJ, 150: 489-495.
2. Kojima G, Liljas AEM, Iliffe S (2019). Frailty syndrome: implications and challenges for health care policy. Risk Manag Healthc Policy, 12: 23-30.
3. Eeles EM, White SV, O'Mahony SM, Bayer AJ, Hubbard RE (2012). The impact of frailty and delirium on mortality in older inpatients. Age Ageing, 41: 412-416.
4. Turner G, Clegg A, British Geriatrics Society, Age UK; Royal College of General Prac-tioners (2014). Best practice guidelines for the management of frailty: a British Geri-atrics Society, Age UK and Royal College of General Practitioners report. Age Ageing, 43: 744-747.
5. Mitnitski AB, Mogilner AJ, Rockwood K (2001). Accumulation of deficits as a proxy measure of aging. Scientific-WorldJournal, 1: 323-336.
6. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC (2012). Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc, 60: 1487-1492.
7. Liu ZY, Wang ZD, Li LZ, Chu XF, Zhu YS, Shi JM, Xie XJ, Jin L, Wang Y (2016). Association of CRP gene polymorphisms with CRP levels, frailty and comorbidity in an elderly Chinese population: results from RuLAS. Age Ageing, 45: 360-365.
8. Lin HS, McBride RL, Hubbard RE (2018). Frailty and anesthesia-risks during and post-surgery. Local Reg Anesth, 11: 61-73.
9. Fang X, Shi J, Song X, Mitnitski A, Tang Z, Wang C, Yu P, Rockwood K (2012). Frailty in relation to the risk of falls, frac-tures and mortality in older Chinese adults: Results from the Beijing longitudi-nal study of aging. J Nutr Health Aging, 16: 903-907.
10. Ma L, Zhang L, Sun F, Li Y, Tang Z (2018). Frailty in Chinese older adults with hyper-tension: Prevalence, associated factors, and prediction for long-term mortality. J Clin Hypertens (Greenwich), 20: 1595-1602.
11. Zhu Y, Liu Z, Wang Y, Wang Z, Shi J, Xie X, Jin L, Chu X, Wang X (2016). Agree-ment between the frailty index and phe-notype and their associations with falls and overnight hospitalizations. Arch Ger-ontol Geriatr, 66: 161-165.
12. Wagstaff A, Yip W, Lindelow M, Hsiao WC (2009). China's Health System and its Re-form: A Review of Recent Studies. Health Econ, 18: S7-23.
13. Chen Y, Yin Z, Xie Q (2014). Suggestions to ameliorate the inequity in urban/rural allocation of healthcare resources in Chi-na. Int J Equity Health, 13: 34.
14. Ding Y, Smith HJ, Fei Y, et al (2013). Fac-tors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces China. Bull World Health Organ, 91: 64–69.
15. Xing, W, Ao, L, Xiao, H, Cheng, L, Liang, Y, Wang, J (2018). Nurses' Attitudes to-ward, and Needs for Online Learning: Differences between Rural and Urban Hospitals in Shanghai, East China. Int J Environ Res Public Health, 15: E1495.
16. Sun, X, Chen, Y, Tong, X, Feng, Z, Wei, L, Zhou, D, Feng, D (2014). The use of an-nual physical examinations among the el-derly in rural China: a cross-sectional study. BMC Health Serv Res, 14: 16.
17. Graf C (2008). The Lawton instrumental ac-tivities of daily living scale. Am J Nurs, 108: 52-62.
18. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y (2010). Sarco-penia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing, 39: 412-423.
19. van Poppel M N, Chinapaw M J, Mokkink L B, van Mechelen W, Terwee CB (2010). Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med, 40: 565-600.
20. Chen N, Li X, Wang J, Zhou C, Wang C (2018). Rural-urban differences in the as-sociation between disability and body mass index among the oldest-old in Chi-na. Arch Gerontol Geriatr, 81: 98-104.
21. Li CL, Stanaway FF, Lin JD, Chang HY (2018). Frailty and health care use among community-dwelling older adults with di-abetes: a population-based study. Clin In-terv Aging, 13: 2295-2300.
22. Lee JS, Auyeung TW, Leung J, Kwok T, Woo J (2014). Transitions in frailty states among community-living older adults and their associated factors. J Am Med Dir Assoc, 15: 281-28.
23. Ng TP, Feng L, Nyunt MS, Larbi A, Yap KB (2014). Frailty in older persons: multi-system risk factors and the Frailty Risk Index (FRI). J Am Med Dir Assoc, 15: 635-642.
24. Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Anderson CS (2002). Long-term disability after first-ever stroke and related prognostic factors in the Perth Community Stroke Study, 1989-1990. Stroke, 33: 1034-1040.
25. Scherbakov N, Sandek A, Doehner W (2015). Stroke-related sarcopenia: specific characteristics. J Am Med Dir Assoc, 16: 272-276.
26. Meyer-Ruesenberg B, Richard G (2010). New insights into the underestimated impairment of quality of life in age-related macular degeneration - a review of the lit-erature. Klin Monbl Augenheilkd, 227: 646-652 [In German].
27. Vanasse G J, Berliner N (2010). Anemia in elderly patients: an emerging problem for the 21st century. Hematology Am Soc Hema-tol Educ Program, 2010: 271-25.
28. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013). Frailty in elderly people. Lancet, 381: 752-762.
29. de Vries NM, van Ravensberg CD, Hob-belen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW (2012). Ef-fects of physical exercise therapy on mo-bility, physical functioning, physical activi-ty and quality of life in community-dwelling older adults with impaired mo-bility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev, 11: 136-149.
30. Boulos C, Salameh P, Barberger-Gateau P (2016). Malnutrition and frailty in com-munity dwelling older adults living in a rural setting. Clin Nutr, 35: 138-143.
31. Pessanha FP, Lustosa LP, Carneiro JA, et al (2017). Body Mass Index and Its Rela-tionship with Disability, Chronic Diseas-es and Frailty in Older People: A Com-parison of the Lipschitz and Who Classi-fications. J Frailty Aging, 6: 24-28.
32. García-Esquinas E, José García-García F, León-Muñoz LM, et al (2015). Obesity, fat distribution, and risk of frailty in two population-based cohorts of older adults in Spain. Obesity (Silver Spring), 23: 847-855.
33. Hubbard RE, Lang IA, Llewellyn DJ, Rock-wood K (2010). Frailty, body mass index, and abdominal obesity in older people. J Gerontol A Biol Sci Med Sci, 65: 377-381.
Published
2019-09-03
How to Cite
1.
GU J, CHEN H, GU X, SUN X, PAN Z, ZHU S, YOUNG D. Frailty and Associated Risk Factors in Elderly People with Health Examination in Rural Areas of China. Iran J Public Health. 48(9):1663-1670.
Section
Original Article(s)