Multidimensional Frailty among Community-Dwelling Older Adults: Prevalence, Risk Factors, and Protective Factors
DOI:
https://doi.org/10.18041/1900-3803/entramado.2.13443Keywords:
Older Adults, Frailty, Risk Factors, Protective Factors, Community-Dwelling, AgingAbstract
Introduction: Most studies on frailty among older adults have been approached from a physiological perspective, although a multidimensional frailty approach that integrates physical, psychological, and social domains has recently gained attention. Objective: To identify the risk and protective factors associated with multidimensional frailty and to estimate the prevalence of frailty from a multidimensional perspective among community-dwelling older adults. Methods: An analytical observational study was conducted with 219 community-dwelling older adults. The Odds ratio test and risk calculations were applied. Frailty was measured using the Tilburg Frailty Indicator (TFI). Results: The prevalence of frailty was 49.8% overall, 54.2% among women, and 44.6% among men. The following risk factors were identified: balance problems, vision problems, hearing problems, recent onset of chronic illness, multiple pathologies, polypharmacy, recent falls, history of abuse, depressed mood, memory problems, anxiety symptoms, low income, spousal illness, and living alone. In contrast, regular physical activity, positive lifestyle perception, effective coping ability, life satisfaction, and a strong social support network were identified as protective factors. Conclusion: Frailty is associated with a combination of physiological, psychological, and social factors, rather than exclusively physical conditions.
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1. AGREE, Emily.; GLASER, Karen. Demography of Informal Caregiving. In: Int Handb Popul Aging. 2009; Charter 29 p. 647-668. https://doi.org/10.1007/978-1-4020-8356- 3_29
2. ALVARADO GARCÍA, Alejandra María.; SALAZAR MAYA, Angela María. Análisis del concepto de envejecimiento. En: Gerokomos. 2014. vol. 25, no. 2. p. 57-62. https://doi.org/10.4321/S1134- 928X2014000200002
3. BALASCH-BERNAT, Mercè; SENTANDREU-MAÑÓ, Trinidad; M. TOMÁS, José M.; CEBRIÀ I IRANZO, Maria A.; TORTOSA-CHULIÁ, Maria A.; ARNAL-GÓMEZ, Anna; CEZÓN-SERRANO, Natalia. Deepening the understanding of the structural validity of the Tilburg Frailty Indicator. In: Aging Clin Exp Res. 2023. vol. 35, p. 1263–1271. https://doi.org/10.1007/s40520-023-02407-w
4. BERGMAN, Howard; BÉLAND, Francois; KARUNANANTHAN, Sathya; HUMMEL, Silvia; HOGAN, David; WOLFSON, Christina. Dévelopment d'un cadre de travail pour comprendre et étudier la fragilité. In: Gérontologie et société. 2014. Vol. 27, no. 109(2). 15-19. https://doi.org/10.3917/gs.109.0015
5. BERGMAN, Howard; FERRUCCI, Luigi; GURALNIK, Jack; HOGAN, David; HUMMEL, Silvia; KARUNANANTHAN, Sathya; WOLFSO, Christina. Frailty: An Emerging Research and Clinical Paradigm—Issues and Controversies. In: Journal of Gerontology July, 2007. Series A, vol. 62, no.7. p. 731-737. https://doi.org/10.1093/gerona/62.7.731
6. BESSA, Bruno; COELHO, Tiago; RIBEIRO, Óscar. Social frailty dimensions and frailty models over time. In: Arch Gerontol Geriatr. 2021. Nov-Dec; vol. 97:104515. https://doi.org/10.1016/j.archger.2021.104515
7. BRIGOLA, Allan G.; ROSSETTI, Estefani; RODRIGUES DOS SANTOS, Bruna; LIBERALESSO-NERI, Anita; ZAZZETTA, Marissa; INOUYE, Keika; IOST-PAVARINI, Sofia. Relationship between cognition and frailty in older adults: A systematic review. In: Dement. Neuropsychol. vol. 9, no 2. p. 110-119. https://doi.org/10.1590/1980-57642015DN92000005
8. BROWN, Patrick; ROOSE, Steven; O’BOYLE, Kaleigh; CIARLEGLIO, Adam; MAAS, Benjamin; IGWE, Kay; CHUNG, Sarah; GOMEZ Stephanie; NAQVI, Maleeha; BRICKMAN Adam M; RUTHERFORD, Bret. Frailty and its correlates in adults with late life depression. In: Am. J. Geriatr. Psychiatry. 2020, vol. 28, no 2. p.145-154. https://doi.org/10.1016/j.jagp.2019.10.005
9. BUNT, S.; STEVERINK, N.; OLTHOF, J.; VAN DER SCHANS, CP.; HOBBELEN, JSM. (2017). Social frailty in older adults: a scoping review. In: Eur J Ageing. 2017, Jan 31; vol. 14, no. 3. p. 323-334. https://doi.org/10.1007/s10433-017-0414-7
10. CHEN, Si; CHEN, Tao; KISHIMOTO, Hiro; YATSUGI, Harukaze; KUMAGA, Shuzo. Associations of objectively measured patterns of sedentary behavior and physical activity with frailty status screened by the frail scale in Japanese Community-dwelling older adults. In: J Sports Sci Med. 2020; vol. 19, no.1. p. 166-174. PMID: 32132840
11. COLLARD, Rose; BOTER, Han; SCHOEVERS, Robert; OUDE VOSHAAR, Richard. Prevalence of frailty in community-dwelling older persons: a systematic review. In: J. Am. Geriatr. Soc.. 2012. Vol. 60, no. 8. P.1487–1492. https://doi.org/10.1111/j.1532-5415.2012.04054.x
12. CUNHA, Ana Isabel Lopes; VERONESE, Nicola; DE MELO BORGES, Sheila; RICCI, Natalia Aquaroni. Frailty as a predictor of adverse outcomes in hospitalized older adults: A systematic review and meta-analysis. In: Ageing Res Rev. 2019 Dec; vol. 56. https://doi.org/10.1016/j.arr.2019.100960
13. FERNANDES, Juliana; GOMES, Cristina Dos Santos; GUERRA, Ricardo Oliveira; PIRKLE, Catherine M.; VAFAEI, Afshin; CURCIO, Carmen Lucía; DORNELAS DE ANDRADE, Armele. Frailty syndrome and risk of cardiovascular disease: Analysis from the International Mobility in Aging Study. In: Arch Gerontol Geriatr. 2021 Jan-Feb; vol. 92:104279. https://doi.org/10.1016/j.archger.2020.104279
14. FERRUCCI, Luigi; CAVAZZINI, Cristina; CORSI, Anna; BARTALI, Benedetta; RUSSO, Cristina R.; LAURETANI, Fulvio; BANDINELLI, Stefania; GURALNIK, Jack M. Biomarkers of frailty in older persons. In: J Endocrinol Invest. octubre 2002. vol. 25, no. 10. Suppl. p. 10-15. https://pubmed.ncbi.nlm.nih.gov/12508906/
15. RIED, Linda P.; FERRUCCI, Luigi; DARER, Jonathan; WILLIAMSON, Jeff D.; ANDERSON, Gerard. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. In: J Gerontol A Biol Sci Med Sci. marzo 2004. vol. 59, no. 3, p. M255-M263. https://doi.org/10.1093/gerona/59.3.M255
16. FRIED, Linda P.; TANGEN, Catherine M.; WALSTON, Jeremy; NEWMAN, Anne B.; HIRSCH, Calvin; GOTTDIENER, John; SEEMAN, Teresa.; TRACY, Russell; KOP, Willem J.; BURKE, Gregory; MCBURNIE, Mary Ann. Frailty in older adults: evidence for a phenotype. In: The Journals of Gerontology. March, 2001. Series A, vol. 56, no. 3. p. M146-M157. https://doi.org/10.1093/gerona/56.3.M146
17. FURMAN, David; CAMPISI, Judith; VERDIN, Eric; CARRERA-BASTOS, Pedro; TARG, Sasha; FRANCESCHI, Claudio; FERRUCCI, Luigi; GILROY, Derek W.; FASANO, Alessio; MILLER, Gary W.; MILLER, Andrew H.; MANTOVANI, Alberto; WEYAND, Cornelia; BARZILAI, Nir; GORONZY, Jörg J.; RANDO, Thomas A.; EFFROS, Rita B.; LUCIA, Alejandro; KLEINSTREUER, Nicole; SLAVICH, George M. Chronic inflammation in the etiology of disease across the life span. In: Nat Med. diciembre 2019. vol. 25, no. 12, p. 1822-1832. https://doi.org/10.1038/s41591-019-0675-0
18. GALE, Catharine R.; WESTBURY, Laura; COOPER, Cyrus. Social isolation and loneliness as risk factors for the progression of frailty: the English Longitudinal Study of Ageing. In: Age Ageing. mayo 2018. vol. 47, no. 3, p. 392-397. https://doi.org/10.1093/ageing/afx188
19. GIFFORD, Katherine A.; BELL, Steven P.; LIU, Dan; NEAL, Jennifer E.; TURCHAN, Melissa; SHAH, Amy S.; JEFFERSON, Angela L. Frailty Is Related to Subjective Cognitive Decline in Older Women without Dementia. In: J Am Geriatr Soc. septiembre 2019. vol. 67, no. 9, p. 1803-1811. https://doi.org/10.1111/jgs.15972
20. GOBBENS, Robbert J. J.; LUIJKX, Katrien G.; WIJNEN-SPONSELEE, Monique T.; SCHOLS, Jos M. G. A. Toward a conceptual definition of frail community dwelling older people. In: Nurs Outlook. enero-febrero 2010. vol. 58, no. 2, p. 76-86. https://doi.org/10.1016/j.outlook.2009.09.005
21. GOBBENS, Robbert J. J.; VAN ASSEN, Marcel A. L. M. Explaining frailty by lifestyle. In: Arch Gerontol Geriatr. septiembre-octubre 2016. vol. 66, p. 49-53. https://doi.org/10.1016/j.archger.2016.04.011
22. GOBBENS, Robbert J. J.; VAN ASSEN, Marcel A. L. M. Associations between multidimensional frailty and quality of life among Dutch older people. In: Arch Gerontol Geriatr. noviembre-diciembre 2017. vol. 73, p. 69-76. https://doi.org/10.1016/j.archger.2017.07.007
23. GOBBENS, Robbert J. J.; VAN ASSEN, Marcel A. L. M. Associations of Environmental Factors with Quality of Life in Older Adults. In: Gerontologist. febrero 2018. vol. 58, no. 1, p. 101-110. https://doi.org/10.1093/geront/gnx051
24. GOBBENS, Robbert J. J.; BOERSMA, Petra; UCHMANOWICZ, Izabella; SANTIAGO, Livia María. The Tilburg Frailty Indicator (TFI): New Evidence for Its Validity. In: Clin Interv Aging. febrero 2020. vol. 15, p. 265-274. https://doi.org/10.2147/CIA.S243233
25. GOBBENS, Robbert J. J. Frailty in Community-Dwelling Older People. In: Healthcare. agosto 2023. vol. 11, no. 16, artículo 2298. https://doi.org/10.3390/healthcare11162298
26. GOBEIL-LAVOIE, Anne; CHOUINARD, Marie-Claude; DANISH, Ahmad; HUDON, Catherine. Characteristics of self-management among patients with complex health needs: A thematic analysis review. In: BMJ Open. mayo 2019. vol. 9, no. 5, e028344. https://doi.org/10.1136/bmjopen-2018-028344
27. GOMES, Caroline de Oliveira; PIRKLE, Catherine M.; ZUNZUNEGUI, María Victoria; GUEDES, Daniela Teles; BARBOSA, Juliana Fernandes; HWANG, Patricia; GUERRA, Ricardo Oliveira. Frailty and life course violence: The International Mobility in Aging Study. In: Arch Gerontol Geriatr. mayo-junio 2018. vol. 76, p. 26-33. https://doi.org/10.1016/j.archger.2018.02.002
28. GORDON, Emily H.; PEEL, Nancye M.; SAMANTA, Moumita; THEOU, Olga; HOWLETT, Susan E.; HUBBARD, Ruth E. Sex differences in frailty: A systematic review and meta-analysis. In: Exp Gerontol. abril 2017. vol. 89, p. 30-40. https://doi.org/10.1016/j.exger.2016.12.021
29. HERR, Matthieu; ROBINE, Jean-Marie; AEGERTER, Pierre; ARVIEU, Jean-Jacques; ANKRI, Joël. Contribution of socioeconomic position over life to frailty differences in old age: comparison of life-course models in a French sample of 2350 old people. In: Ann Epidemiol. septiembre 2015. vol. 25, no. 9, p. 674-680.e1. https://doi.org/10.1016/j.annepidem.2015.05.006
30. HLADEK, Michelle D.; GILL, Jessica; BANDEEN-ROCHE, Karen; WALSTON, Jeremy; ALLEN, Jessica K.; HINKLE, Janice L.; LORIG, Kate; SZANTON, Sarah L. High coping self-efficacy associated with lower odds of pre-frailty/frailty in older adults with chronic disease. In: Aging Ment Health. enero 2020. vol. 24, no. 1, p. 75-81. https://doi.org/10.1080/13607863.2019.1639136
31. HOOGENDIJK, Emiel O.; SUANET, Bianca; DENT, Elsa; DEEG, Dorly J. H.; AARTSEN, Marja J. Adverse effects of frailty on social functioning in older adults: Results from the Longitudinal Aging Study Amsterdam. In: Maturitas. enero 2016. vol. 83, p. 45-50. https://doi.org/10.1016/j.maturitas.2015.09.002
32. HOOGENDIJK, Emiel O.; AFILALO, Jonathan; ENSRUD, Kristine E.; KOWAL, Paul; ONDER, Graziano; FRIED, Linda P. Frailty: implications for clinical practice and public health. In: Lancet. octubre 2019. vol. 394, no. 10206, p. 1365-1375. https://doi.org/10.1016/S0140-6736(19)31786-6
33. JOPP, Daniela S.; ROTT, Christoph. Adaptation in very old age: exploring the role of resources, beliefs, and attitudes for centenarians' happiness. In: Psychol Aging. junio 2006. vol. 21, no. 2, p. 266-280. https://doi.org/10.1037/0882-7974.21.2.266
34. KAMIL, Rebecca J.; BETZ, Joshua; POWERS, Becky B.; PRATT, Sheila; KRITCHEVSKY, Stephen; AYONAYON, Hilsa N.; HARRIS, Tamara B.; HELZNER, Elizabeth; DEAL, Jennifer A.; MARTIN, Kathryn R.; PETERSON, Matthew D.; SATTERFIELD, Suzanne; SIMONSICK, Eleanor M.; LIN, Frank R.; Health ABC Study. Association of Hearing Impairment with Incident Frailty and Falls in Older Adults. In: J Aging Health. mayo 2016. vol. 28, no. 4, p. 644-660. https://doi.org/10.1177/0898264315608730
35. KANG, Ji-Young; KIM, Chang-Hwan; SUNG, Eun-Ju; SHIN, Hyeon-Cheol; SHIN, Won-Joon; JUNG, Kyung-Ho. The Association between Frailty and Cognition in Older Adult Women. In: Korean J Fam Med. mayo 2016. vol. 37, no. 3, p. 164-170. https://doi.org/10.4082/kjfm.2016.37.3.164
36. KELLY, Sarah; O'BRIEN, Irene; SMUTS, Kathryn; O'SULLIVAN, Maria; WARTERS, Amanda. Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort. In: BMC Geriatr. junio 2017. vol. 17, no. 121. https://doi.org/10.1186/s12877-017-0508-2
37. KOSITSAWAT, Jiraporn; BARRY, Lisa C.; KUCHEL, George A. C-reactive protein, vitamin D deficiency, and slow gait speed. In: J Am Geriatr Soc. septiembre 2013. vol. 61, no. 9, p. 1574-1579. https://doi.org/10.1111/jgs.12403
38. LEE, Jenny S. W.; AUYEUNG, Tung Wai; LEUNG, Jason; KWOK, Timothy; WOO, Jean. Transitions in Frailty States Among Community-Living Older Adults and Their Associated Factors. In: J Am Med Dir Assoc. abril 2014. vol. 15, no. 4, p. 281-286. https://doi.org/10.1016/j.jamda.2013.12.002
39. LIU, Ching-Ti; LYASS, Andrei; LARSON, Martin G.; MASSARO, Joseph M.; WANG, Nancy; D'AGOSTINO, Ralph B.; BENJAMIN, Emelia J.; MURABITO, Joanne M. Biomarkers of oxidative stress are associated with frailty: the Framingham Offspring Study. In: Age (Dordr). febrero 2016. vol. 38, no. 1, artículo 1. https://doi.org/10.1007/s11357-015-9864-z
40. LIU, Mengting; HOU, Tingting; NKIMBENG, Marcia; LI, Yiyang; TAYLOR, Julie; SUN, Xueya; TANG, Shijun; SZANTON, Sarah L. Associations between symptoms of pain, insomnia and depression, and frailty in older adults: A cross-sectional analysis of a cohort study. In: Int J Nurs Stud. mayo 2021. vol. 117, artículo 103873. https://doi.org/10.1016/j.ijnurstu.2021.103873
41. MACHADO, Isabela T.; ORLANDI, Fabiana S.; GOMES, Grace Angélica D.; SAY, Karina G.; GUARISCO, Letícia; ORLANDI, Ariene A.; POTT-JUNIOR, Henrique; ZAZZETTA, Marisa S. Frailty state transitions among non-frail and vulnerable older adults: Does mobility performance really matter? In: Geriatr Nurs. noviembre-diciembre 2021. vol. 42, no. 6, p. 1367-1372. https://doi.org/10.1016/j.gerinurse.2021.09.007
42. MAKIZAKO, Hyuma; SHIMADA, Hiroyuki; TSUTSUMIMOTO, Koji; LEE, Sangyoon; DOI, Takao; NAKAKUBO, Shigeru; HOTTA, Ryo; SUZUKI, Toshiyuki. Social frailty in community-dwelling older adults as a risk factor for disability. In: J Am Med Dir Assoc. noviembre 2015. vol. 16, no. 11, p. 1003.e7-1003.e11. https://doi.org/10.1016/j.jamda.2015.08.023
43. MENÉNDEZ-GONZÁLEZ, Laura; IZAGUIRRE-RIESGO, Amaia; TRANCHE-IPARRAGUIRRE, Salvador; MONTERO-RODRÍGUEZ, Ángel; ORTS-CORTÉS, María Isabel. Prevalencia y factores asociados de fragilidad en adultos mayores de 70 años en la comunidad. In: Aten Primaria. diciembre 2021. vol. 53, no. 10, artículo 102128. https://doi.org/10.1016/j.aprim.2021.102128
44. MORLEY, John E. Cognitive frailty: A new geriatric syndrome? In: Eur Geriatr Med. agosto 2015. vol. 6, no. 5, p. 408-411. https://doi.org/10.1016/j.eurger.2015.05.012
45. NGUYEN, Quoc D.; WU, Chenkai; ODDEN, Michelle C.; KIM, Dae Hyun. Multimorbidity Patterns, Frailty, and Survival in Community-Dwelling Older Adults. In: J Gerontol A Biol Sci Med Sci. agosto 2019. vol. 74, no. 8, p. 1265-1270. https://doi.org/10.1093/gerona/gly205
46. PAHOR, Marco; GURALNIK, Jack M.; AMBROSIUS, Walter T.; BLAIR, Steven; BONDS, Denise E.; CHURCH, Timothy S.; et al. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. In: JAMA. mayo 2014. vol. 311, no. 23, p. 2387-2396. https://doi.org/10.1001/jama.2014.5616
47. PILOTTO, Alberto; CUSTODERO, Carlo; MAGGI, Stefania; POLIDORI, Maria Cristina; VERONESE, Nicola; FERRUCCI, Luigi. A multidimensional approach to frailty in older people. In: Ageing Res Rev. julio 2020. vol. 60, artículo 101047. https://doi.org/10.1016/j.arr.2020.101047
48. ROCKWOOD, Kenneth. What would make a definition of frailty successful? In: Age Ageing. septiembre 2005. vol. 34, no. 5, p. 432-434. https://doi.org/10.1093/ageing/afi146
49. ROCKWOOD, Kenneth; MITNITSKI, Arnold; SONG, Xue; STEEN, Björn; SKOOG, Ingmar. Long-term risks of death and institutionalization of older adults in relation to deficit accumulation at age 70. In: J Am Geriatr Soc. junio 2006. vol. 54, no. 6, p. 975-979. https://doi.org/10.1111/j.1532-5415.2006.00738.x
50. ROCKWOOD, Kenneth; MITNITSKI, Arnold. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. In: Clin Geriatr Med. febrero 2011. vol. 27, no. 1, p. 17-26. https://doi.org/10.1016/j.cger.2010.08.008
51. RODRÍGUEZ-MAÑAS, Leocadio; FÉART, Catherine; MANN, Gordon; VIÑA, José; CHATTERJI, Somnath; CHODZKO-ZAJKO, Wojtek; GONZÁLEZ-COLAÇO HARMAND, Marie; BERGMAN, Howard; CARCAILLON, Laure; NICHOLSON, Caroline; SCUTERI, Angelo; SINCLAIR, Alan; PELÁEZ, Martha; VAN DER CAMMEN, Tischa; BELAND, François; BICKENBACH, Jerome; DELAMARCHE, Patrick; FERRUCCI, Luigi; FRIED, Linda P.; GUTIÉRREZ-ROBLEDO, Luis Miguel; ROCKWOOD, Kenneth; RODRÍGUEZ-ARTALEJO, Fernando; SERVIDDIO, Giuseppe; VEGA, Ernesto; FOD-CC Group. Searching for an operational definition of frailty: a Delphi method based consensus statement: the Frailty Operative Definition-Consensus Conference Project. In: J Gerontol A Biol Sci Med Sci. enero 2013. vol. 68, no. 1, p. 62-67. https://doi.org/10.1093/gerona/gls119
52. SÁNCHEZ-GARCÍA, Sergio; GARCÍA-PEÑA, Carmen; SALVÀ, Antoni; SÁNCHEZ-ARENAS, Rosalinda; GRANADOS-GARCÍA, Víctor; CUADROS-MORENO, Juan; VELÁZQUEZ-OLMEDO, Laura; CÁRDENAS-BAHENA, Ángel. Frailty in community-dwelling older adults: association with adverse outcomes. In: Clin Interv Aging. 2017. vol. 12, p. 1003-1010. https://doi.org/10.2147/CIA.S139860
53. SCHOUFOUR, Jolanda D.; ECHTELD, Michael A.; BASTIAANSE, Lisette P.; EVENHUIS, Heleen M. The use of a frailty index to predict adverse health outcomes (falls, fractures, hospitalization, medication use, comorbid conditions) in people with intellectual disabilities. In: Res Dev Disabil. febrero 2015. vol. 38, p. 39-47. https://doi.org/10.1016/j.ridd.2014.12.001
54. SHAMLIYAN, Tatyana; TALLEY, Kristine M. C.; RAMAKRISHNAN, Rajeev; KANE, Robert L. Association of frailty with survival: A systematic literature review. In: Ageing Res Rev. marzo 2013. vol. 12, no. 2, p. 719-736. https://doi.org/10.1016/j.arr.2012.03.001
55. SIRIWARDHANA, Dilanka D.; HARDOON, Shireen; RAIT, Greta; WEERASINGHE, Maheshi C.; WALTERS, Kate R. Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. In: BMJ Open. marzo 2018. vol. 8, no. 3, e018195. https://doi.org/10.1136/bmjopen-2017-018195
56. SONNENFELD, Mandi H.; AL SNIH, Soham. Vision Impairment and Frailty among Older Mexican Americans: Findings from the Hispanic Established Population for the Epidemiologic Study of the Elderly. In: Arch Phys Med Rehabil. octubre 2021. vol. 102, no. 10, p. e89. https://doi.org/10.1016/j.apmr.2021.07.737
57. SWENOR, Bonnielin K.; LEE, Moon J.; TIAN, Jing; VARADARAJ, Varshini; BANDEEN-ROCHE, Karen. Visual Impairment and Frailty: Examining an Understudied Relationship. In: J Gerontol A Biol Sci Med Sci. febrero 2020. vol. 75, no. 3, p. 596-602. https://doi.org/10.1093/gerona/glz182
58. THIEDE, Ryan; TOOSIZADEH, Nima; MILLS, Joseph L.; ZAKY, Mohamed; MOHLER, Jane; NAJAFI, Bijan. Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. In: Clin Biomech. febrero 2016. vol. 32, p. 1-7. https://doi.org/10.1016/j.clinbiomech.2015.12.002
59. THIRUCHELVAM, Kaeshaelya; BYLES, Julie; SHAHZAD, Syed; EGAN, Nicholas; KAIRUZ, Therese. Prevalence and association of continuous polypharmacy and frailty among older women: A longitudinal analysis over 15 years. In: Maturitas. abril 2021. vol. 146, p. 18-25. https://doi.org/10.1016/j.maturitas.2021.01.005
60. TIAN, Rong; TREVENEN, Michelle; FORD, Andrew H.; JAYAKODY, Dona M. P.; HANKEY, Graeme J.; YEAP, Bu B.; GOLLEDGE, Jonathan; FLICKER, Leon; ALMEIDA, Osvaldo P. Hearing impairment and frailty in later life: The Health in Men Study (HIMS). In: Maturitas. febrero 2022. vol. 156, p. 30-36. https://doi.org/10.1016/j.maturitas.2021.10.008
61. TURNER, Graeme; CLEGG, Alan. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. In: Age Ageing. noviembre 2014. vol. 43, no. 6, p. 744-747. https://doi.org/10.1093/ageing/afu138
62. VAN ASSEN, Marcel A. L. M.; PALLAST, Elske G.; EL FAKIRI, Fatima; GOBBENS, Robbert J. J. Measuring frailty in Dutch community-dwelling older people: Reference values of the Tilburg Frailty Indicator (TFI). In: Arch Gerontol Geriatr. septiembre-octubre 2016. vol. 67, p. 120-129. https://doi.org/10.1016/j.archger.2016.07.005
63. VERGHESE, Joe; HOLTZER, Roee; LIPTON, Richard B.; WANG, Chengxuan. High-sensitivity C-reactive protein and mobility disability in older adults. In: Age Ageing. julio 2012. vol. 41, no. 4, p. 541-545. https://doi.org/10.1093/ageing/afs038
64. VERONESE, Nicola; CUSTODERO, Carlo; CELLA, Antonio; DEMURTAS, Jacopo; ZORA, Sara; MAGGI, Stefania; BARBAGALLO, Mario; SABBÀ, Carlo; FERRUCCI, Luigi; PILOTTO, Alberto. Prevalence of multidimensional frailty and pre-frailty in older people in different settings: A systematic review and meta-analysis. In: Ageing Res Rev. diciembre 2021. vol. 72, artículo 101498. https://doi.org/10.1016/j.arr.2021.101498
65. VERONESE, Nicola; STUBBS, Brendon; NOALE, Marianna; SOLMI, Marco; PILOTTO, Alberto; VAONA, Alberto; DEMURTAS, Jacopo; MUELLER, Christoph; HUNTLEY, Jonathan; CREPALDI, Gaetano; MAGGI, Stefania. Polypharmacy Is Associated With Higher Frailty Risk in Older People: An 8-Year Longitudinal Cohort Study. In: J Am Med Dir Assoc. julio 2017. vol. 18, no. 7, p. 624-628. https://doi.org/10.1016/j.jamda.2017.02.009
66. VROTSOU, Kalliopi; MACHÓN, Mónica; RIVAS-RUIZ, Francisco; CARRASCO, Estefanía; CONTRERAS-FERNÁNDEZ, Eugenio; MATEO-ABAD, Maider; GÜELL, Carolina; VERGARA, Itziar. Psychometric properties of the Tilburg Frailty Indicator in older Spanish people. In: Arch Gerontol Geriatr. septiembre-octubre 2018. vol. 78, p. 203-212. https://doi.org/10.1016/j.archger.2018.05.024
67. WANG, Huihui; WANG, Jing; XIE, Boqin; LIU, Bangzhong; WANG, Junqiao. Multidimensional frailty and its risk factors among older residents in long-term care facilities in Shanghai, China. In: Int J Nurs Sci. septiembre 2021. vol. 8, no. 3, p. 298-303. https://doi.org/10.1016/j.ijnss.2021.06.003
68. WORLD HEALTH ORGANIZATION. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization. 2001. ISBN 92-4-154542-9. https://iris.who.int/server/api/core/bitstreams/6f65baa4-134d-4450-ba52-bb4962a4444b/content
69. World Health Organization (WHO). (2015). Informe mundial sobre el envejecimiento y la salud. Ginebra: Organización Mundial de la Salud. https://www.who.int/es/publications/i/item/9789241565042.
70. ZAMORA-SÁNCHEZ, Juan José; URPÍ-FERNÁNDEZ, Ana María; SASTRE-RUS, Meritxell; LUMILLO-GUTIÉRREZ, Iris; GEA-CABALLERO, Vicente; JÓDAR-FERNÁNDEZ, Lina; JULIÁN-ROCHINA, Iván; ZABALETA-DEL-OLMO, Edurne. The Tilburg Frailty Indicator: A psychometric systematic review. In: Ageing Res Rev. abril 2022. vol. 76, artículo 101588. https://doi.org/10.1016/j.arr.2022.101588
71. ZHAO, Wenjie; ZHANG, Yan; LIU, Xiaolei; YUE, Jianping; HOU, Lin; XIA, Xiaoqian; ZUO, Zhihao; LIU, Yan; JIA, Shasha; DONG, Birong; GE, Ning. Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China Health and Aging Trend Study. In: J Affect Disord. diciembre 2020. vol. 277, p. 970-976. https://doi.org/10.1016/j.jad.2020.08.070
72. ZILLER, Christina; BRAUN, Thomas; THIEL, Christian. Frailty phenotype prevalence in community-dwelling older adults according to physical activity assessment method. In: Clin Interv Aging. 2020. vol. 15, p. 343-355. https://doi.org/10.2147/CIA.S238204
73. ZUCCHELLI, Alberto; VETRANO, Davide L.; GRAND, Giulia; CALDERÓN-LARRAÑAGA, Amaia; FRATIGLIONI, Laura; MARENGONI, Alessandra; RIZZUTO, Debora. Comparing the prognostic value of geriatric health indicators: a population-based study. In: BMC Med. octubre 2019. vol. 17, no. 185, p. 1-10. https://doi.org/10.1186/s12916-019-1418-2
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