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Old or frail: what tells us more?
Hanneke Schuurmans1, Nardi Steverink, Siegwart Lindenberg
1University Hospital Groningen, Department of Internal Medicine, PO Box 30 001, 9700 RB, the Netherlands. schuurmans@dds.nl
Background:
Selecting elderly persons who need geriatric interventions and making accurate treatment decisions are recurring challenges in geriatrics. Chronological age, although often used, does not seem to be the best selection criterion. Instead, the concept of frailty, which indicates several concurrent losses in resources, can be used.
Methods:
The predictive values of chronological age and frailty were investigated in a large community sample of persons aged 65 years and older, randomly drawn from the register of six municipalities in the northern regions of the Netherlands (45% of the original addressees). The participants' generative capacity to sustain well-being (i.e., self-management abilities) was used as the main outcome measure.
Results:
When using chronological age instead of frailty, both too many and too few persons were selected. Furthermore, frailty related more strongly (with beta values ranging from -.25 to -.39) to a decline in the participants' self-management abilities than did chronological age (with beta values ranging from -.06 to -.14). Chronological age added very little to the explained variances of all outcomes once frailty was included.
Conclusions:
Using frailty as the criterion to select older persons at risk for interventions may be better than selecting persons based only on their chronological age.