Instrumental Activities of Daily Living as a Potential Marker of Frailty A Study of 7364 Community-Dwelling Elderly Women (the EPIDOS Study)
Fati Nourhashemi,Sandrine Andrieu,Sophie Gillette-Guyonnet,Bruno Vellas,Jean Louis Albarede,Hélène Grandjean +5 more
TLDR
The results confirmed that women with disability on at least one IADL item are frailer because they had more associated disorders, poorer cognitive function and more frequent falls.Abstract:
Background. A number of clinical conditions have been shown to be associated with frailty in elderly people. We hypothesized that incapacities on the Instrumental Activities of Daily Living (IADLs) scale could make it possible to identify this population. We investigated the associations between IADL incapacities and the various known correlates of frailty in a cohort of community-dwelling elderly women. Methods. Cross-sectional analysis was carried out on the data from 7364 women aged over 75 years (EPIDOS Study). The IADL was the dependent variable. Sociodemographic, medical, and psychological performance measures were obtained during an assessment visit. Falls in the previous 6 months and fear of falling were also ascertained. Body composition was measured by dual-energy x-ray absorptiometry. The factors associated with disability in at least one IADL were included in a logistic regression model. Results. Thirty-two percent of the population studied had disability in at least one IADL item. This group was significantly older (81.7 � 4.1 yr vs 79.8 � 3.4 yr), had more frequent histories of heart disease, stroke, depression or diabetes, and was socially less active ( p � .001). These associations persisted after multivariate analysis. Cognitive impairment as assessed by the Pfeiffer test (Pfeiffer score � 8) was closely associated with disabilities on the IADL (OR 3.101, 95% confidence interval [CI] 2.19‐4.38). Falls and fear of falling were also more frequent in the group of women with an abnormal IADL ( p � .001) but only fear of falling remained significantly associated with incapacities on at least one IADL item after logistic regression (OR 1.47, 95% CI 1.28‐1.69). Women with disability on at least one IADL item also had lower bone mineral density, this was independent of the other factors. Conclusion. Our results confirmed that women with disability on at least one IADL item are frailer because they had more associated disorders, poorer cognitive function and more frequent falls. Disabilities on this scale could be a good tool for identifying individuals at risk of frailty among elderly persons living at home and in apparent good health. This finding requires confirmation by longitudinal studies.read more
Citations
More filters
Journal ArticleDOI
A global clinical measure of fitness and frailty in elderly people
Kenneth Rockwood,Xiaowei Song,Chris MacKnight,Howard Bergman,David B. Hogan,Ian McDowell,Arnold Mitnitski +6 more
TL;DR: The ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools are determined.
Journal ArticleDOI
Phenotype of Frailty: Characterization in the Women's Health and Aging Studies
Karen Bandeen-Roche,Qian Li Xue,Luigi Ferrucci,Jeremy D. Walston,Jack M. Guralnik,Paulo H.M. Chaves,Scott L. Zeger,Linda P. Fried +7 more
TL;DR: The frailty definition developed in the CHS is applicable across diverse population samples and identifies a profile of high risk of multiple adverse outcomes and is consistent with the widely held theory that conceptualizes frailty as a syndrome.
Journal ArticleDOI
Management of Adult Stroke Rehabilitation Care: a clinical practice guideline.
Pamela W. Duncan,Richard D. Zorowitz,Barbara E. Bates,John Y. Choi,Jonathan J. Glasberg,Glenn D. Graham,Richard C. Katz,Kerri Lamberty,Dean M. Reker +8 more
TL;DR: A growing body of evidence indicates that patients do better with a well-organized, multidisciplinary approach to post-acute rehabilitation after a stroke, and greater adherence to post–acute stroke rehabilitation guidelines was associated with improved patient outcomes.
Journal ArticleDOI
The I.A.N.A. task force on frailty assessment of older people in clinical practice
TL;DR: A comprehensive review of the definitions and assessment tools on frailty in clinical practice and research was performed, combining evidence derived from a systematic review of literature along with an expert opinion of a European, Canadian and American Geriatric Advisory Panel (GAP).
Journal ArticleDOI
Frailty syndrome: a transitional state in a dynamic process
TL;DR: A better understanding of these clinical changes and their underlying mechanisms may confirm the impression held by many geriatricians that increasing frailty is distinguishable from ageing and in consequence is potentially reversible.
References
More filters
Book
Principles of geriatric medicine and gerontology
TL;DR: The new Fifth Edition has been significantly reorganized to enhance geriatric assessment skills, general medical management, management of specific diseases, surgical management, gender issues in clinical geriatrics, and more.
Journal ArticleDOI
Fear of falling and restriction of mobility in elderly fallers
TL;DR: It is indicated that about one-third of elderly people develop a fear of falling after an incident fall and this issue should be specifically addressed in any rehabilitation programme.
Journal ArticleDOI
Fall-related factors and risk of hip fracture: the EPIDOS prospective study
Patricia Dargent-Molina,F. Favier,Hélène Grandjean,C. Baudoin,Anne-Marie Schott,E. Hausherr,P. J. Meunier,Gérard Bréart +7 more
TL;DR: It is concluded that neuromuscular and visual impairments, as well as femoral-neck BMD, are significant and independent predictors of the risk of hip fracture in elderly mobile women, and that their combined assessment improves the prediction of hip fractures.
Journal ArticleDOI
Shared risk factors for falls, incontinence, and functional dependence, unifying the approach to geriatric syndromes
TL;DR: It may be possible to restore compensatory ability and prevent or delay the onset of several geriatric syndromes and, perhaps, functional dependence by modifying a shared set of predisposing factors.
Journal ArticleDOI
The aging of America. Impact on health care costs.
TL;DR: The rapid growth of the oldest age groups will have a major impact on future health care costs, and future costs for Medicare, nursing homes, dementia, and hip fractures are projected.
Related Papers (5)
Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living
M. P. Lawton,Elmne M. Brody +1 more