BMC Geriatrics (Oct 2024)

Risk factors for hospitalisation in community-dwelling pre-frail and frail older people: results of a longitudinal study

  • M. G. A. M. van der Velde,
  • L. P. M. Op Het Veld,
  • E. van Rossum,
  • M. A. C. Jansen,
  • H. R. Haak,
  • M. N. T. Kremers

DOI
https://doi.org/10.1186/s12877-024-05458-4
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 10

Abstract

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Abstract Background Older adults account for a large proportion of hospital admissions. In this study we aim to bridge a gap between medical and psychosocial factors in predicting hospitalisation. Methods Demographic and social characteristics of community-dwelling pre-frail and frail older people were collected by questionnaires every six months during a two year follow-up. Hospital admission within this period was dichotomised as yes/no. To define pre-frailty and frailty the Fried frailty criteria were used. Analysis of risk factors for hospitalisation was performed using multivariable logistic regression. Results Hospitalised participants (n = 1803) were more often male and frail in comparison to not-hospitalised participants. They also experienced more chronic diseases (54.5% ≥ 4 chronic diseases), poorer self-perceived health (SPH) (76.4% fair to very poor) and lack of informal care (20.1%). In multivariable logistic regression male gender (Odds ratio (OR) 1.65, p < 0.001), frailty (vs. pre-frailty) (OR 1.66, p = 0.002), reporting lower SPH (OR 3.12, p < 0.001) and lacking informal care (OR 1.69, p < 0.001) showed significant associations with hospital admission. Subgroup analysis of pre-frail and frail participants, showed consistent associations between male gender (respectively OR 1.61, p < 0.001 ; OR 1.72, p = 0.085), lower SPH (OR 2.23, p = 0.001; OR 31.16, p < 0.001), lack of informal care (OR 1.64, p = 0.005; OR 2.63, p = 0.012) and hospitalisation. Conclusion Frailty, male gender, lower SPH and lack of informal care are risk factors for hospitalisation within community-dwelling older people, showing the need of a holistic approach to possibly prevent hospitalisation. Further research should focus on evaluating individual factors for hospitalisation, particularly targeting pre-frail individuals.

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