Frailty and disability in the elderly: a diagnostic dilemma

Decreased reserves in multiple organ systems identify frailty syndrome in the elderly. However, its clinical diagnostic approach may be hard, particularly in patients with chronic diseases. The purpose of the study was to delineate the role of disability in the frailty syndrome in a group of hospitalized elderly people. A total of 150 consecutive patients (62 males/88 females), aged between 64 and 97 years and 1-2 days before hospital discharge, were submitted to several geriatric scales designed to assess disability and/or morbidity. All the geriatric scales used showed an elevated percentage of abnormal values both in females and in males. Nevertheless, the activities of daily living (ADL), instrumental activities of daily living (IADL), Tinetti balance index (TBI), Barthel index (BI) scores showed significantly better values in men than in women (p=0.007, =0.02, =0.02 and =0.01, respectively). This preliminary cross-sectional study, underlines the fact that all geriatric tests employed have shown pathological scores, but those of the ADL, IADL, TBI and BI scores exploring disability were significantly better in males than in females. The mismatch between functional and morbidity tests seems to support the hypothesis that a disability state may be independent from morbidity.