Frailty index and its relation to falls and overnight hospitalizations in elderly Chinese people: A population-based study

To investigate current status of frailty index (FI) defined as deficit accumulation and its relations to falls and overnight hospitalizations in an elderly Chinese population. A cross-sectional cohort study. All of the 31 valiages in Jiang'an township, a typical medium-sized township in Rugao city, China. Overall 1773 participants aged 70-84 years were randomly recruited. A FI including symptoms, activities of daily living, co-morbidities, cognitive and psychological function was constructed using 45 health deficits. The mean of FI was 0.14 in men and 0.19 in women. According to a usual FI cut-point of 0.25, 8.2% of men and 23.2% of women were classified as frail. Literate participants had lower levels of FI than their illiterate counterpart. In men, the FI was positively related to age (r = 0.186, p <.001), with a mean rate of deficit accumulation of 0.032 (on a log scale) per year. Each increment of 0.01 on the FI was associated with significantly increased risks of falls and overnight hospitalizations, with odds ratios of 1.05 (95% CI: 1.03, 1.07) and 1.05 (95% CI: 1.03, 1.08). Similarly, the aforementioned associations were observed in women. Education level moderated the associations of FI with falls in men and women. Elderly Chinese women were more frail than men. The FI significantly increased with chronological age and was significantly associated with falls and overnight hospitalizations, and education level may play an important role. This study provides preliminary but crucial evidences for future researches on frailty in China.