Can resources moderate the impact of levels of frailty on adverse outcomes among (pre-) frail older people? A longitudinal study

BMC Geriatrics

Research Article

Bart H.L. Ament¹  Gertrudis I.J.M. Kempen¹  Anna J.H.M. Beurskens²  Erik van Rossum³  Linda P.M. Op het Veld³  KlaasJan Hajema⁴  Henrica C.W. de Vet⁵ 

[1] CAPHRI, Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands;Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN, Heerlen, The Netherlands;CAPHRI, Care and Public Health Research Institute, Department of Family Practice, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands;Centre of Research Autonomy and Participation for Persons with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, P.O. Box 550, 6400 AN, Heerlen, The Netherlands;CAPHRI, Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands;Community Health Service South Limburg, Academic Collaborative Centres Public Health (ACC), Geleenbeeklaan 2, 6166 GR, Sittard-Geleen, The Netherlands;Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, De Boelelaan 1089A, 1081 HV, Amsterdam, The Netherlands;

关键词: Frailty;    Older people;    Resources;    Moderating factors;    Mortality;    Hospitalisation;    Disability;   

DOI  :  10.1186/s12877-017-0583-4

 received in 2016-11-23, accepted in 2017-08-08,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHigher levels of frailty result in higher risks of adverse frailty outcomes such as hospitalisation and mortality. There are, however, indications that more factors than solely frailty play a role in the development of these outcomes. The presence of resources, e.g. sufficient income and good self-management abilities, might slow down the pathway from level of frailty to adverse outcomes (e.g. mortality). In the present paper we studied whether resources (i.e. educational level, income, availability of informal care, living situation, sense of mastery and self-management abilities) moderate the impact of the level of frailty on the adverse outcomes mortality, hospitalisation and the development of disability over a two-year period.MethodsLongitudinal data on a sample of 2420 community-dwelling pre-frail and frail older people were collected. Participants filled out a questionnaire every six months, including measures of frailty, resources and outcomes. To study the moderating effects of the selected resources their interaction effects with levels of frailty on outcomes were studied by means of multiple logistics and linear regression models.ResultsFrail older participants had increased odds of mortality and hospitalisation, and had more deteriorating disability scores compared to their pre-frail counterparts. No moderating effects of the studied resources were found for the outcomes mortality and hospitalisation. Only for the outcome disability statistically significant moderating effects were present for the resources income and living situation, yet these effects were in the opposite direction to what we expected. Overall, the studied resources showed hardly any statistically significant moderating effects and the directions of the trends were inconsistent.ConclusionsFrail participants were more at risk of mortality, hospitalisation, and an increase in disability. However, we were unable to demonstrate a clear moderating effect of the studied resources on the adverse outcomes associated with frailty (among pre-frail and frail participants). More research is needed to increase insight into the role of moderating factors. Other resources or outcome measures should be considered.

【 授权许可】

CC BY   
© The Author(s). 2017