Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review

Joan Vermeulen, Jacques C L Neyens, Erik van Rossum, Marieke D Spreeuwenberg, Luc P de Witte, Joan Vermeulen, Jacques C L Neyens, Erik van Rossum, Marieke D Spreeuwenberg, Luc P de Witte

Abstract

Background: Disability in Activities of Daily Living (ADL) is an adverse outcome of frailty that places a burden on frail elderly people, care providers and the care system. Knowing which physical frailty indicators predict ADL disability is useful in identifying elderly people who might benefit from an intervention that prevents disability or increases functioning in daily life. The objective of this study was to systematically review the literature on the predictive value of physical frailty indicators on ADL disability in community-dwelling elderly people.

Methods: A systematic search was performed in 3 databases (PubMed, CINAHL, EMBASE) from January 1975 until April 2010. Prospective, longitudinal studies that assessed the predictive value of individual physical frailty indicators on ADL disability in community-dwelling elderly people aged 65 years and older were eligible for inclusion. Articles were reviewed by two independent reviewers who also assessed the quality of the included studies.

Results: After initial screening of 3081 titles, 360 abstracts were scrutinized, leaving 64 full text articles for final review. Eventually, 28 studies were included in the review. The methodological quality of these studies was rated by both reviewers on a scale from 0 to 27. All included studies were of high quality with a mean quality score of 22.5 (SD 1.6). Findings indicated that individual physical frailty indicators, such as weight loss, gait speed, grip strength, physical activity, balance, and lower extremity function are predictors of future ADL disability in community-dwelling elderly people.

Conclusions: This review shows that physical frailty indicators can predict ADL disability in community-dwelling elderly people. Slow gait speed and low physical activity/exercise seem to be the most powerful predictors followed by weight loss, lower extremity function, balance, muscle strength, and other indicators. These findings should be interpreted with caution because the data of the different studies could not be pooled due to large variations in operationalization of the indicators and ADL disability across the included studies. Nevertheless, our study suggests that monitoring physical frailty indicators in community-dwelling elderly people might be useful to identify elderly people who could benefit from disability prevention programs.

Figures

Figure 1
Figure 1
Flow-chart of selection process.

References

    1. Lally F, Crome P. Understanding frailty. Postgrad Med J. 2007;83:16–20. doi: 10.1136/pgmj.2006.048587.
    1. Covinsky K. Aging, arthritis, and disability. Arthritis Rheum. 2006;55:175–176. doi: 10.1002/art.21861.
    1. Rochat S, Cumming RG, Blyth F, Creasey H, Handelsman D, Le Couteur DG, Naganathan V, Sambrook PN, Seibel MJ, Waite L. Frailty and use of health and community services by community-dwelling older men: the concord health and ageing in men project. Age Ageing. 2010;1:1–6.
    1. Boyd CM, Xue QL, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118:1225–31. doi: 10.1016/j.amjmed.2005.01.062.
    1. Al Snih S, Graham JE, Ray LA, Samper-Ternent R, Markides KS, Ottenbacher KJ. Frailty and incidence of activities of daily living disability among older merica mericans. J Rehabil Med. 2009;41:892–7. doi: 10.2340/16501977-0424.
    1. Ensrud KE, Ewing SK, Cawthon PM, Fink HA, Taylor BC, Cauley J, Dam TT, Marshall LM, Orwoll ES, Cummings SR. A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men. J Am Geriatr Soc. 2009;57:492–8. doi: 10.1111/j.1532-5415.2009.02137.x.
    1. Morley JE, Perry HM, Miller DK. Something about frailty. J Gerontol A Biol Sci Med Sci. 2002;57A:698–704.
    1. Markle-Reid M, Browne G. Conceptualizations of frailty in relation to older adults. J Adv Nurs. 2003;44:58–68. doi: 10.1046/j.1365-2648.2003.02767.x.
    1. Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C. Frailty: an emerging research and clinical paradigm-issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62:731–7.
    1. Levers MJ, Estabrooks CA, Ross Kerr JC. Factors contributing to frailty: literature review. J Adv Nurs. 2006;56:282–91. doi: 10.1111/j.1365-2648.2006.04021.x.
    1. Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, Ershler WB, Harris T, Fried LP. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006;54:991–1001. doi: 10.1111/j.1532-5415.2006.00745.x.
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–56. doi: 10.1093/gerona/56.3.M146.
    1. Avlund K. Disability in old age. Longitudinal population-based studies of the disablement process. Dan Med Bull. 2004;51:315–349.
    1. Altman DG. Systematic reviews of evaluations of prognostic variables. BMJ. 2001;323:224–228. doi: 10.1136/bmj.323.7306.224.
    1. Stuck AE, Walthert JM, Nikolaus T, Büla CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-dwelling elderly people: a systematic literature review. Soc Sci & Med. 1999;48:445–469. doi: 10.1016/S0277-9536(98)00370-0.
    1. Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for Reporting observational studies. Plos Med. 2007;4:1623–1627.
    1. Tas U, Verhagen AP, Bierma-Zeinstra SMA, Odding E, Koes BW. Prognostic factors of disability in older people: a systematic review. Br J of Gen Prac. 2007;57:319–323.
    1. Ostir GV, Markides KS, Black SA, Goodwin JS. Lower body functioning as a predictor of subsequent disability among older Mexican Americans. J Gerontol A Biol Sci Med Sci. 1998;53:M491–5.
    1. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55:M221–31. doi: 10.1093/gerona/55.4.M221.
    1. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–61. doi: 10.1056/NEJM199503023320902.
    1. Al Snih S, Raji MA, Markides KS, Ottenbacher KJ, Goodwin JS. Weight change and lower body disability in older Mexican Americans. J Am Geriatr Soc. 2005;53:1730–7. doi: 10.1111/j.1532-5415.2005.53522.x.
    1. Al Snih S, Markides KS, Ottenbacher KJ, Raji MA. Hand grip strength and incident ADL disability in elderly Mexican Americans over a seven-year period. Aging Clin Exp Res. 2004;16:481–6.
    1. Rothman MD, Leo-Summers L, Gill TM. Prognostic significance of potential frailty criteria. J Am Geriatr Soc. 2008;56:2211–116. doi: 10.1111/j.1532-5415.2008.02008.x.
    1. Gill TM, Murphy TE, Barry LC, Allore HG. Risk factors for disability subtypes in older persons. J Am Geriatr Soc. 2009;57:1850–5. doi: 10.1111/j.1532-5415.2009.02443.x.
    1. Gill TM, Allore H, Holford TR, Guo Z. The development of insidious disability in activities of daily living among community-living older persons. Am J Med. 2004;117:484–91. doi: 10.1016/j.amjmed.2004.05.018.
    1. Jacobs JM, Cohen A, Hammerman-Rozenberg R, Azoulay D, Maaravi Y, Stessman J. Going outdoors daily predicts long-term functional and health benefits among ambulatory older people. J Aging Health. 2008;20:259–72. doi: 10.1177/0898264308315427.
    1. Stessman J, Hammerman-Rozenberg R, Maaravi Y, Cohen A. Effect of exercise on ease in performing activities of daily living from age 70 to 77: the Jerusalem Longitudinal Study. J Am Geriatr Soc. 2002;50:1934–1938. doi: 10.1046/j.1532-5415.2002.50603.x.
    1. Shinkai S, Kumagai S, Fujiwara Y, Amano H, Yoshida Y, Wanatabe S, Ishizaki T, Suzuki T, Shibata H. Predictors for the onset of functional decline among initially non-disabled older people living in a community during a 6-year follow-up. Geriatr & Gerntol Intern. 2003;3:31–S39. doi: 10.1111/j.1444-0594.2003.00094.x.
    1. Shinkai S, Watanabe S, Kumagai S, Fujiwara Y, Amano H, Yoshida H, Ishizaki T, Yukawa H, Suzuki T, Shibata H. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing. 2000;29:441–6. doi: 10.1093/ageing/29.5.441.
    1. Ishizaki T, Watanabe S, Suzuki T, Shibata H, Haga H. Predictors for functional decline among nondisabled older Japanese living in a community during a 3-year follow-up. Am Geriatr Soc. 2000;48:1424–9.
    1. Rosano C, Newman AB, Katz R, Hirsch CH, Kuller LH. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults. J Am Geriatr Soc. 2008;56:1618–25. doi: 10.1111/j.1532-5415.2008.01856.x.
    1. Arnold AM, Newman AB, Cushman M, Ding J, Kritchevsky S. Body weight dynamics and their association with physical function and mortality in older adults: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2010;65:63–70.
    1. Giampaoli S, Ferrucci L, Cecchi F, Lo Noce C, Poce A, Dima F, Santaquilani A, Vescio MF, Menotti A. Hand-grip strength predicts incident disability in non-disabled older men. Age & Ageing. 1999;28:283–8. doi: 10.1093/ageing/28.3.283.
    1. Van Den Brink CL, Picavet H, Van Den Bos GA, Giampaoli S, Nissinen A, Kromhout D. Duration and intensity of physical activity and disability among European elderly men. Disabil Rehabil. 2005;27:341–7. doi: 10.1080/09638280400018452.
    1. Gill TM, Williams CS, Tinetti ME. Assessing risk for the onset of functional dependence among older adults: the role of physical performance. J Am Geriatr Soc. 1995;43:603–9.
    1. Gill TM, Williams CS, Richardson ED, Tinetti ME. Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. J Gerontol A Biol Sci Med Sci. 1996;51A:M2830–M288.
    1. Sonn U, Frandin K, Grimby G. Instrumental activities of daily living related to impairments and functional limitations in 70-year-olds and changes between 70 and 76 years of age. Scand J Rehabil Med. 1995;27:119–28.
    1. Lee Y. The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults. J Epidemiol Community Health. 2000;54:123–9. doi: 10.1136/jech.54.2.123.
    1. Sarkisian CA, Liu H, Gutierrez PR, Seeley DG, Cummings SR, Mangione CM. Modifiable risk factors predict functional decline among older women: a prospectively validated clinical prediction tool. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48:170–8.
    1. Wu SC, Leu SY, Li CY. Incidence of and predictors for chronic disability in activities of daily living among older people in Taiwan. J Am Geriatr Soc. 1999;47:1082–6.
    1. Balzi D, Lauretani F, Barchielli A, Ferrucci L, Bandinelli S, Buiatti E. Risk factors for disability in older persons over 3-year follow-up. Age & Ageing. 2010;39:92–8. doi: 10.1093/ageing/afp209.
    1. Onder G, Penninx BW, Ferrucci L, Fried LP, Guralnik JM, Pahor M. Measures of physical performance and risk for progressive and catastrophic disability: results from the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci. 2005;60:74–9. doi: 10.1093/gerona/60.1.74.
    1. Ritchie CS, Locher JL, Roth DL, McVie T, Sawyer P, Allman R. Unintentional weight loss predicts decline in activities of daily living function and life-space mobility over 4 years among community-dwelling older adults. J Gerontol A Biol Sci Med Sci. 2008;63:67–75.
    1. Tinetti ME, Inouye SK, Gill TM, Doucette JT. Shared risk factors for falls, incontinence, and functional dependence. JAMA. 1995;273:1348–1353. doi: 10.1001/jama.273.17.1348.
    1. Wang L, Van Belle G, Kukull WB, Larson EB. Predictors of functional change: a longitudinal study of non-demented people aged 65 and older. J Am Geriatr Soc. 2002;50:1525–1534. doi: 10.1046/j.1532-5415.2002.50408.x.

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