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Frailty in younger adults in hospital

E H Gordon1, N M Peel1, R E Hubbard1

  • 1From the Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

QJM : Monthly Journal of the Association of Physicians
|July 19, 2023
PubMed

Insights

Younger hospitalized adults experience frailty, impacting their length of stay. This study highlights frailty in younger inpatients and its association with adverse outcomes, urging further understanding.

Area of Science:

  • Gerontology and Geriatric Medicine
  • Acute Care Medicine
  • Health Services Research

Background:

  • Frailty is well-documented in older acute care patients, but understudied in younger adults.
  • Understanding frailty in younger hospitalized populations is crucial for comprehensive care.

Purpose of the Study:

  • To measure frailty in hospitalized adults aged 18 and over.
  • To compare frailty levels and characteristics between younger, middle-aged, and older adult inpatients.
  • To examine the association of frailty with length of stay and discharge destination in younger adults.

Main Methods:

  • Secondary analysis of prospectively collected cohort data from 910 patients across four Australian hospitals.
  • Frailty Index (FI) scores and domains were assessed using the interRAI Acute Care instrument.
  • Comparison of FI across age groups (18-49, 50-69, ≥70 years) and multivariable logistic regression for outcomes.

Main Results:

  • Younger adults (23.5%) had a mean FI of 0.19, with 27% identified as frail (FI > 0.25).
  • Commonly affected frailty domains in younger adults included mood/behavior, health symptoms, nutrition, and pain; 50% had ≥3 comorbidities.
  • Frailty significantly increased the risk of prolonged length of stay (OR=1.77, P<0.001) but not unfavorable discharge (OR=1.40, P=0.20) in younger adults.

Conclusions:

  • Frailty is prevalent in younger patients admitted to acute care settings.
  • Frailty in younger hospitalized adults is associated with adverse outcomes, particularly prolonged hospital stays.
  • This research provides a foundational understanding of frailty in younger hospitalized adults, necessitating further investigation.
Abstract

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