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Prevalence, transitions and factors predicting transition between frailty states among rural community-dwelling older adults in Malaysia

Ahmad NS 1 , Hairi NN 1 , Said MA 1 , Kamaruzzaman SB 2 , Choo WY 1 , Hairi F 1 Show all authors , Othman S 3 , Ismail N 4 , Peramalah D 1 , Kandiben S 1 , Mohd Ali Z 5 , Ahmad SN 5 , Abdul Razak I 5 , Bulgiba A 1

Affiliations 

  • 1 Centre for Epidemiology and Evidence Based Practice, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 2 Division of Geriatrics, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 3 Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 4 Tobacco Control Unit, Ministry of Health Malaysia, Putrajaya, Malaysia
  • 5 Negeri Sembilan State Health Department (JKNNS), Negeri Sembilan, Malaysia
PLoS One, 2018;13(11):e0206445.
PMID: 30395649 DOI: 10.1371/journal.pone.0206445

Abstract

OBJECTIVES: This study aims to describe the prevalence and transitions of frailty among rural-community dwelling older adults in Malaysia and to analyse factors associated with different states of frailty transition. Frailty was conceptualized using modified Fried phenotype from the Cardiovascular Health Study.

DESIGN: This is a prospective longitudinal study with 12-months follow up among older adults in Malaysia.

SETTING: Kuala Pilah, a district in Negeri Sembilan, which is one of the fourteen states in Malaysia.

PARTICIPANTS: 2,324 community-dwelling older Malaysians aged 60 years and older.

RESULTS: The overall prevalence of frailty in this study was 9.4% (95% CI 7.8-11.2). The prevalence increased at least three-fold with every 10 years of age. This increase was seen higher in women compared to men. Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p<0.05). During the 12-months follow-up, our study showed that the transition towards greater frailty states were more likely (22.9%) than transition toward lesser frailty states (19.9%) while majority (57.2%) remained unchanged. Multivariate logistic regression analysis showed that presence of low physical activity increased the likelihood of worsening transition towards greater frailty states by three times (OR 2.9, 95% CI 2.2-3.7) and lowered the likelihood of transition towards lesser frailty states (OR 0.3, 95% CI 0.2-0.4).

CONCLUSION: Frailty is reported among one in every eleven older adults in this study. The prevalence increased across age groups and was higher among women than men. Frailty possesses a dynamic status due to its potential reversibility. This reversibility makes it a cornerstone to delay frailty progression. Our study noted that physical activity conferred the greatest benefit as a modifiable factor in frailty prevention.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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