Frailty syndrome among older adults after hospitalization: A structural equation modeling analysis

• Published in: Applied nursing research Vol. 67; p. 151601
• Main Authors: Marchiori, Gianna Fiori, dos Santos Tavares, Darlene Mara, Martins, Sónia Patrícia Vilar, Dias, Cláudia Camila, Fernandes, Lia Paula Nogueira Sousa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-2022
• Subjects: Aged; Frail elderly; Geriatric nursing; Longitudinal studies; Patient discharge; Geriatric nursing; Patient discharge; Aged; Longitudinal studies; Frail elderly
• ISSN: 0897-1897; 1532-8201
• DOI: 10.1016/j.apnr.2022.151601

To analyze the association of demographic, clinical, health and functional capacity variables as predictors of frailty in older adults after one year of hospital discharge.
There is still insufficient research with older persons after hospital discharge that evaluated the predictive variables for an increase in the frailty score. Identifying the characteristics that result in greater risk helps to guide care and interventions.
Longitudinal study involving 129 older adults who completed the follow-up. The Frailty Phenotype was used according to Fried and sociodemographic, clinical, health and functional capacity variables. Analysis was performed using structural equation modeling.
At admission, the highest percentage (53.4%) of older adults were pre-frail, followed by frail (23.3%) and non-frail (23.3%). After a year of discharge, there was a decrease in the frail condition (22.5%) and pre-frail (52.7%); and an increase in non-frail (24.8%). At baseline, 29.5% showed impairment in only one component, with an increase in the percentage at follow-up (37.2%). The highest number of morbidities and hospital readmissions and lower IADL scores were predictors of an increase in the frailty score during follow-up.
The prevalence of frailty was high among hospitalized older adults and after follow-up. Identifying the risk factors allows early and individualized interventions with reduction of negative outcomes. During hospitalization, a multidimensional assessment of older adults should be performed, especially with regard to frailty. The recognition of frailty predictors directs the care of older persons considering their individual needs and allows the improvement and/or stability of the frailty condition.
•Frailty is a public health problem and is associated with negative health outcomes.•Structural equation modeling identifies the trajectory of frailty in older adults.•Morbidities, hospital readmissions and instrumental activities of daily living scores were predictors of frailty.•The identification of frailty directs interventions to prevent adverse outcomes.