PLoS ONE (Jan 2018)

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

  • Nur Sakinah Ahmad,
  • Noran Naqiah Hairi,
  • Mas Ayu Said,
  • Shahrul Bahyah Kamaruzzaman,
  • Wan Yuen Choo,
  • Farizah Hairi,
  • Sajaratulnisah Othman,
  • Norliana Ismail,
  • Devi Peramalah,
  • Shathanapriya Kandiben,
  • Zainudin Mohd Ali,
  • Sharifah Nor Ahmad,
  • Inayah Abdul Razak,
  • Awang Bulgiba

DOI
https://doi.org/10.1371/journal.pone.0206445
Journal volume & issue
Vol. 13, no. 11
p. e0206445

Abstract

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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.