Journal
ARCHIVES OF GERONTOLOGY AND GERIATRICS
Volume 53, Issue 1, Pages 79-83Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.archger.2010.06.013
Keywords
Frailty index; Comprehensive geriatric assessment; Clinical frailty scale; Timed up-and-go; Functional reach; Mortality
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Funding
- QEII Health Science Foundation
- Canadian Institutes of Health Research
- British Geriatrics Society
- Royal College of Physicians of Edinburgh
- Magdalen College Oxford
- Wingate Foundation
- Dalhousie Medical Research Foundation
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We set out to describe the relationship between impaired balance, mobility and frailty, and relate these to risk of death. We examined a subsample of 1295 community-dwelling non-demented adults from the second wave of the Canadian Study of Health and Aging (CSHA), a prospective population-based cohort study. Frailty index (FI) scores were constructed from a standardized comprehensive geriatric assessment (FI-CGA). History of mobility impairments and falls were assessed. Timed-up-and-go (TUG) and functional reach (FR) performance were measured. The CSHA clinical frailty scale (CFS) was judged by a physician. Adverse outcomes were determined at CSHA-3, conducted 5 years later. The FI-CGA varied in association with impaired mobility and balance. A history of mobility problems was demonstrable at FI-CGA scores >0.12. This level of frailty also represented the most marked deterioration in performance measures (TUG and FR). FI-CGA scores best predicted mortality (HR 1.04 +/- 0.02), proving to be a dominating factor in multivariate regression models that included mobility and balance markers. Only at the upper range of FI-CGA reported (>0.45) did all participants demonstrate mobility impairment. Impaired balance and mobility contribute to frailty, but neither is sufficient to define a participant as frail. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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