Original Article

The Evaluation of Frailty in the Elderly and Affecting Biopsychosocial Factors: A Cross-Sectional Observational Study


Background: We aimed to evaluate the frequency of frailty and the affecting factors in people living in our society over 65 yr old.

Methods: Our descriptive and cross-sectional study included 261 individuals aged 65 and over who applied to Ankara Training and Research Hospital family practice centers and district polyclinics from 1 Jan to 1 Feb 2020. The participants were asked to complete a sociodemographic data form, FRAIL Scale, Katz Daily Living Activities Scale, Lawton&Brody Instrumental Activities of Daily Living Scale and Geriatric Depression Scale Short Form.

Results: According to the FRAIL Scale results: 35 people were found to be frail (13.4%), 115 to be pre-frail (44.1%). No frailty was observed in 111 people (42.5%). While the mean score of the Katz Activities of Daily Living Scale was found to be 5.65±0.71, the mean score of the Lawton&Brody Instrumental Activities of Daily Living Scale was found to be 6.65±1.69. In the geriatric depression evaluation, mild, medium or severe depression was detected in 87 participants (33.2%). As the level of frailty increased, the Geriatric Depression Scale score climbed significantly (P<0.001). In frail individuals, Lawton&Brody Scale scores were significantly lower (P<0.001). In our study: a correlation was found between frailty and female gender, being single, low income, low educational level, obesity, polypharmacy and decreased physical activity. Additionally, as the number of children increase frailty in women increases therewithal.

Conclusion: Elderly people had high frailty. Polypharmacy, depression and reduced physical activity were the more frequent in frail elderly. In frail females, the number of children was significantly higher.


1. Buckinx F, Rolland Y, Reginster JY, et al (2015). Burden of frailty in the elderly population: perspectives for a public health challenge. Arch Public Health, 73:19.
2. Bouillon K, Kivimaki M, Hamer M. et al (2013). Measures of frailty in population-based studies: an overview. BMC Geriatr, 13:64.
3. Cesari M, Calvani R, Marzetti E (2017). Frail-ty in Older Persons. Clin Geriatr Med, 33:293-303..
4. Morley JE, Vellas B, van Kan GA, et al (2013). Frailty consensus: a call to action. J Am Med Dir Assoc, 14:392-397.
5. Yazan T, Girgin A, Kuru T (2017). Geriatrik Depression: A research on resident for-eigners living in Alanya. Acta Med Alanya, 1:32-37.
6. Duman B, Özel Kızıl ET (2016). Geriatric Depression and its Treatment. Turkiye Klinikleri J Psychiatry-Special Topics, 9(4):1-8.
7. Hsu CH, Tung HH, Clinciu DL, et al (2017). Physical activity: A primary health quality determinant among community-dwelling geriatric women in Taiwan. Int J Qual Health Care, 29:792-796.
8. Pilotto A, Custodero C, Maggi S, et al (2020). A multidimensional approach to frailty in older people. Ageing Res Rev, 60:101047.
9. Lee L, Heckman G, Molnar FJ (2015). Frail-ty: Identifying elderly patients at high risk of poor outcomes. Can Fam Physician, 61:227-231.
10. Morley JE, Malmstrom TK, Miller DK (2012). A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging, 16:601-608.
11. Hymabaccus BAB, Yavuz BB, Doğrul RT, et al (2018). Turkish validity and reliability of the FRAIL scale for measuring frailty in the elderly. 11th Academic Geriatrics Congress Proceedings Book; Academic Geriatrics Society. Antalya.
12. Katz S, et al (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185:914-9.
13. Özkan Pehlivanoğlu EF, Özkan MU, Balcıoğlu H, et al (2018). Adjustment and reliability of Katz Daily Life Activity Measures for elderly in Turkish. Ankara Med J, 18:219-223.
14. Lawton MP, Brody EM (1969). Assessment of older people: self-maintaining and in-strumental activities of daily living. Geron-tologist, 9:179-186.
15. Sheikh JI, Yesavage JA (1986). Geriatric De-pression Scale: Recent evidence and de-velopment of a shorter version. In Clini-cal Gerontology: A Guide to Assessment and Intervention (T. L. Brink, Ed.). Ha-worth, New York, pp. 165-73.
16. Durmaz B, Soysal P, Ellidokuz H, et al (2018). Validity and reliability of geriatric depression scale-15 (short form) in Turk-ish older adults. North Clin Istanb, 5:216-220.
17. Akın S, Mazıcıoglu M, Mucuk S, et al (2015). The prevalence of frailty and related fac-tors in community- dwelling Turkish el-derly according to modified Fried Frailty Index and FRAIL scales. Aging Clin Exp Res, 27:703–709.
18. Walston J, Buta B, Xue Q-L (2018). Frailty Screening and Interventions Considera-tions for Clinical Practice. Clin Geriatr Med, 34:25-38.
19. Woo J, Yu R, Wong M, et al (2015). Frailty Screening in the Community Using the FRAIL Scale. J Am Med Dir Assoc, 16:412-419.
20. Fried LP, Tangen CM, Walston J, et al (2001). Cardiovascular Health Study Col-laborative Research Group. Frailty in old-er adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 56:146-156.
21. Melo Filho J, Moreira NB, Vojciechowski AS, et al (2020). Frailty prevalence and re-lated factors in older adults from south-ern Brazil: A cross-sectional observational study. Clinics (Sao Paulo), 75:e1694.
22. Ma L, Tang Z, Zhang L, et al (2018). Preva-lence of Frailty and Associated Factors in the Community-Dwelling Population of China. J Am Geriatr Soc, 66:559-564.
23. Mendiratta P, Latif R (2021). Clinical Frailty Scale. Stat Pearls, Treasure Island. www.ncbi.nlm.nih.gov/books/NBK559009/
24. Rodda J, Walker Z, Carter J (2011). Depres-sion in older adults. BMJ, 343: d5219.
25. Buigues C, Padilla-Sánchez C, Garrido JF, et al (2015). The relationship between de-pression and frailty syndrome: a system-atic review. Aging Ment Health, 19:762-772.
26. Soysal P, Veronese N, Thompson T, et al (2017). Relationship between depression and frailty in older adults: A systematic review and meta-analysis. Ageing Res Rev, 36:78-87.
27. Katz IR (2004). Depression and frailty: The need for interdisciplinary research. Am J Geriatr Psychiatry, 12:1-5.
28. Feng L, Nyunt MSZ, Feng L, et al (2014). Frailty predicts new and persistent de-pressive symptoms among community-dwelling older adults: findings from Sin-gapore longitudinal aging study. J Am Med Dir Assoc, 15: 76.e7-76.e12.
IssueVol 52 No 1 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v52i1.11678
Depression Frailty Physical activity

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How to Cite
Yengil Taci D, Yılmaz S, Arslan İsmail, Fidancı İzzet, Çelik M. The Evaluation of Frailty in the Elderly and Affecting Biopsychosocial Factors: A Cross-Sectional Observational Study. Iran J Public Health. 2023;52(1):159-165.