Frailty in INstitutionalized older adults from ALbacete. The FINAL Study: rationale, design, methodology, prevalence and attributes.

Background: Little is known about frailty in institutionalized older adults, and there are few longitudinal studies on this topic.

Objective: To determine the prevalence and attributes of frailty in institutionalized Spanish older adults.

Methods: Cross-sectional analysis of basal data of a concurrent cohort study. Methods: Two nursing homes, Vasco Núñez de Balboa and Paseo de la Cuba, in Albacete, Spain. Methods: 331 institutionalized adults older than 65 years. Methods: Frailty was defined by the presence of 3 or more Fried criteria and prefrailty by the presence of 1 or 2: unintentional weight loss, low energy, exhaustion, slowness, and low physical activity. Covariables were sociodemographic, anthropometric, functional, cognitive, affective and of comorbidity. Hospitalization, emergency visits and falls in the 6 previous months was recorded. Differences between non-frail and prefrail as one group and frail participants were analyzed using χ(2) tests, t-Student and logistic regression.

Results: Mean age 84.1 (SD 6.7), with 209 (65.1%) women. 68.8% were frail, 28.4% pre-frail, 2.8% non-frail, and in 2.2% three criteria were not available to determine frailty status. Women were more frequently frail than men (77.1% vs. 22.9%; p<0.001), and frail participants were older (85.1 vs. 82.3; p<0.001) than non-frail ones. Female sex (OR 2.7 95%CI 1.2-6.2), Barthel index (OR 2.2 95%CI 1.2-4.4), depression risk (OR 2.2 95%CI 1.0-4.9) and Short Physical Performance Battery scores (0.7 95%CI 0.6-0.8) were independently associated with frailty status. Frailty had a non-significant association with hospitalization (OR 1.9 95%CI 0.8-4.5) and emergency visits (OR 1.5 95%CI 0.7-3.2) in the previous 6 months.

Conclusions: In a cohort of institutionalized older adults the prevalence of frailty was 68.8% and was associated with adverse health geriatric outcomes.