Factors affecting progression to frailty in community-dwelling older adults during all COVID-19 waves

Frailty, defined as a reduced capacity to manage stress due to multisystem dysfunction, has a significant impact on quality of life, morbidity and mortality. This study aimed to identify the factors influencing the progression to frailty in community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic.

This prospective observational study included non-frail individuals aged 65 years or older admitted to a geriatric outpatient clinic. Evaluation was conducted before (T0) and after (T1) the pandemic. Logistic regression analysis was performed to examine factors associated with progression to frailty.

The final sample comprised 139 participants (mean age 74.8 ± 6.2 years, 60% female). The median follow-up time was 53 months (range, 27-60). Thirty-one participants (22%) developed frailty after the pandemic. In the clinical follow-up (T1), a decrease in the Mini Nutritional Assessment-Short Form score was associated with an increased risk of frailty. In the multivariate logistic regression analysis, four or more doses of the COVID-19 vaccine, sufficient physical activity and a Mini-Mental State Examination score ≥27 points were associated with a lower risk of transition to frailty, while polypharmacy and age ≥75 years were associated with an increased risk.

This study highlights the importance of full vaccination, along with promoting physical activity, mitigating polypharmacy and enhancing cognitive health to prevent the onset of frailty during a viral pandemic.