Zhongguo quanke yixue (Jan 2024)
The Relationship between Multi-dimensional Frailty and Impairment of Activities of Daily Living in Rural Elderly
Abstract
Background Previous studies have confirmed a correlation between physical frailty and impairment of activities of daily living (ADL) in the elderly, but it is still unclear whether there is a correlation of psychological and social frailty in the elderly with their ADL impairment. Objective To investigate the multi-dimensional frailty of the elderly in rural areas and the correlation of dimensions with ADL impairment, so as to provide evidence for preventing disability rural older adults. Methods A cross-sectional study was conducted, older adults aged ≥60 years from 30 administrative villages in 2 cities of Guizhou Province were selected for the study from July to September 2021 (n=1 298) by using a multi-stage cluster sampling method. The demographic characteristics, prevalence of chronic diseases and sleep quality of the subjects were collected by questionnaire, and the multi-dimensional frailty of the elderly was assessed by Chinese version of Tilburg debilitating scale, ADL scale was used to assess the impairment of ADL in the elderly, multivariate Logistic regression was used to analyze the effects of multi-dimensional frailty and its dimensions on the impairment of ADL in the elderly, and the multifactor-adjusted population attributable risk percentage (PARc%) was calculated. Results Of the 1 298 older adults, 498 (38.37%) were with ADL impairment, 40 (3.08%) were with BADL impairment, 494 (38.06%) were with IADL impairment; 382 (29.43%) were with multi-dimensional frailty, 319 (24.58%) were with physical frailty, 567 (43.68%) were with psychological frailty, and 69 (5.32%) were with social frailty. After adjusting for confounding factors of age, gender, education level, marital status, and sleep quality, the results of binary Logistic regression analysis showed that multi-dimensional frailty, physical frailty, and psychological frailty in older adults had effects on and ADL, BADL and IADL impairments (P<0.05). Further analysis of the population attribution risk of multi-dimensional frailty, physical frailty, and psychological frailty for ADL showed that multi-dimensional frailty had the greatest population attributable risk for BALD impairment [PARc% (95%CI) =24.6 (19.1-27.1) ], psychological frailty had a relatively high population attributable risk for ADL impairment [PARc% (95%CI) =18.4 (12.1-24.5) ], BADL impairment [PARc% (95%CI) =23.6 (3.2-33.7) ], and IADL impairment [PARc% (95%CI) =19.4 (12.4-24.7) ] . Conclusion The multi-dimensional frailty, physical frailty and psychological frailty of the rural elderly in Guizhou province are related to the impairment of ADL, BADL and IADL, with greater attribution of psychological frailty for disability. Enhancing screening and interventions for multi-dimensional frailty in older adults, particularly psychological frailty, may reduce the risk of disability in older adults.
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