Medical Sciences
Understanding the Prevalence, Factors, and Patient-Centered and Economic Outcomes of Prefrailty and Frailty in Community-Dwelling Older Singaporean Adults
By Ryan Eyn Kidd Man, Preeti Gupta, Chiew Meng Johnny Wong and 12 others.
Abstract
Introduction
The objective of this study was to determine the prevalence, factors associated with, and patient-centered and economic outcomes of prefrailty and frailty in a multi-ethnic population of community-dwelling older Singaporean adults aged ≥60 years.
Methods
We included 2110 participants (mean age ± SD: 72.4 ± 8.1 years; 52.6% female) from the cross-sectional Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study (2017 to 2022). A modified Fried frailty cross-sectional phenotype classification was used to categorize participants as prefrail or frail, based on them having 1–2 or ≥3 of the following characteristics: underweight (body mass index < 18.5 kg/m2), slowness (sex-specific lowest quintile of time taken to complete a 4 m gait speed test), weakness (sex-specific lowest quintile of grip strength), self-reported exhaustion (score < 10 in the Vitality domain of the 12-item short-form survey), and low physical activity duration (sex-specific lowest quintile of those individuals a non-zero duration). Sociodemographic, clinical and lifestyle factors, patient-centered (health-related quality of life, functional disability, life-space mobility, depressive symptoms, falls and perceived economic hardship) and economic (healthcare expenditure, work productivity loss) outcomes were assessed via standardized clinical testing and/or validated questionnaires. Ordinal logistic regression models with dominance analysis, linear, negative binomial and two-part regression models were utilized to explore the associated factors and patient-centered and economic outcomes of prefrailty and frailty, respectively.