Article

Dimensions and correlates of quality of life according to frailty status: a cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Out 8:56

Department of Internal Medicine, Geriatric Medicine Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Health and Quality of Life Outcomes (Impact Factor: 2.1). 06/2010; 8(1):56. DOI: 10.1186/1477-7525-8-56
Source: PubMed

ABSTRACT There is a lack of knowledge concerning the relationship between two closely-linked multidimensional variables: frailty and quality of life (QOL). The aim of this study was to investigate dimensions and correlates of QOL associated with frailty status among community-dwelling older outpatients.
We conducted a cross-sectional survey of 239 community-dwelling outpatients aged 65+ (mean age 81.5 years) consecutively referred to a geriatric medicine clinic in Italy between June and November 2009. Participants underwent a comprehensive geriatric assessment, including assessment of their frailty status according to the Study of Osteoporotic Fractures (SOF) criteria, and QOL, which was evaluated by using the Older People's QOL (OPQOL) questionnaire. One-way ANOVA and chi-squared tests were used to find correlates of frailty, including QOL dimensions, after stratification of participants in the "robust" (n = 72), "pre-frail" (n = 89) and "frail" (n = 78) groups. Multiple linear regression analyses were performed to find correlates of QOL in the overall sample and among "frail" and "robust" participants.
A negative trend of QOL with frailty status was found for almost all dimensions of QOL (health, independence, home and neighbourhood, psychological and emotional well-being, and leisure, activities and religion) except for social relationships and participation and financial circumstances. Independent correlates of a poor QOL in the total sample were "reduced energy level" (SOF criterion for frailty), depressive status, dependence in transferring and bathing abilities and money management (adjusted R squared 0.39); among "frail" participants the associations were with depressive status and younger age, and among "robust" participants the association was with lower body mass index.
Five out of seven dimensions of QOL were negatively affected by frailty, but only one SOF criterion for frailty was independently related to QOL, after correction for age, functional status and depression. A more advanced age as well as a better affective status were correlates of a better QOL among frail elders. Interventions targeting the QOL in frail community-dwelling older outpatients should consider as outcomes, not only health-related QOL, but also other domains of the QOL.

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Available from: Claudio Bilotta, Jan 08, 2014
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    • "Whereas, Chang et al. (2012) identified slowness as the major contributing component in the physical scale of SF-36, and poor endurance and energy in the mental scale of QOL. Using the Study of the Osteoporotic Fractures (SOF) criteria for frailty evaluation, the study by Bilotta et al. (2010) reported " reduced energy level " as the first predictor of QOL. Thus, little is known on the impact of single components of frailty on mental and physical domains of HRQOL. "
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    • "). However, divergent from other Western- European countries, Italy possesses a large population of those 65 years of age and older who are frail, yet, wanting to age in place (Bilotta et al. 2010; Cuénoud et al. 2009). This increase in the elder population has affected several aspects of Italian society both challenging the resilience of elders as they face new challenges of aging in place. "
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