Prevalence of frailty in residents of senior care facilities and its impact on physical function

Abstract Background Frailty is a common syndrom in older adults with significant effects for public health. It reflects increased vulnerability resulting from age-related decline in physiological function and reserves. The Fried frailty phenotype is widely used, defining frailty by five criteria (unintentional weight loss, weakness, exhaustion, slow gait speed and low physical activity). In older adults, mobility and independence are commonly impaired, both being key determinants of well-being. Frailty is especially prevalent among older adults living in senior care facilities. Purpose As part of our bestform-trial, we assessed the prevalence of frailty among residents of senior care facilities and compared physical function, mobility, and strength between pre-frail/frail and robust individuals. Methods A total of 404 participants (mean age 85.3±6.5 years; 80.7 % women) from 21 senior care facilities were included in the study. Data collection comprises the frailty status, physical function (Short Physical Performance Battery, SPPB), functional mobility (Timed-Up-and-Go-Test, TUG), cardiopulmonary capacity (6-Minute-Walk-Test, 6MWT), muscle strength (handgrip strength of the right and left hand), and degree of assistance required in activities of daily living (ADL) (Barthel-Index, 0–100 points). Analyses were conducted on participants with complete information on frailty status using mixed models that accounted for the cluster effect. Results Frailty status could be determined for 358 participants. Of these, 24.6 % were classified as robust, and 75.4% as pre-frail or frail. Participants classified as robust had significantly higher scores on the SPPB (9.5±2.0 versus 5.9±2.8 points, p0.001), better performance in TUG (10.6±3.2 vs. 19.2±10.0 s, p0.001), longer walking distance in 6MWT (407.2±92.1 vs. 269.4±95.4 m, p0.001), and a higher Barthel-Index (87.3±4.1 vs. 81.7±9.3 points, p0.001). Mean handgrip strength was higher among robust participants compared to prefrail/frail older adults, both for the right hand (27.4±7.5 vs. 20.7±6.2 kg, p0.001) and the left hand (26.1±7.3 vs. 20.7±6.6 kg, p0.001). Conclusion The results show that three quarters of residents in senior care facilities are prefrail or frail, accompanied by significant impairments in physical function, mobility, and strength. Whether training interventions that follow current recommendations – namely progressive multicomponent training – can prevent the onset of frailty should be examined in larger randomised trials in this setting.