AUTHOR=Coelho Tiago , Paúl Constança , Gobbens Robbert J. J. , Fernandes Lia 

TITLE=Determinants of frailty: the added value of assessing medication

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 7 - 2015

YEAR=2015

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2015.00056

DOI=10.3389/fnagi.2015.00056

ISSN=1663-4365

ABSTRACT=This study aims to analyze which determinants predict frailty in general and each frailty domain (physical, psychological, and social), considering the integral conceptual model of frailty, and particularly to examine the contribution of medication in this prediction. A cross-sectional study was designed using a non-probabilistic sample of 252 community-dwelling elderly from three Portuguese cities. Frailty and determinants of frailty were assessed with the Tilburg Frailty Indicator. The amount and type of different daily-consumed medication were also examined. Hierarchical regression analysis were conducted. The mean age of the participants was 79.2 years (±7.3), and most of them were women (75.8%), widowed (55.6%) and with a low educational level (0-4 years: 63.9%). In this study, determinants explained 46% of the variance of total frailty, and 39.8%, 25.3%, and 27.7% of physical, psychological, and social frailty respectively. Age, gender, income, death of a loved one in the past year, lifestyle, satisfaction with living environment and self-reported comorbidity predicted total frailty, while each frailty domain was associated with a different set of determinants. The number of medications independently predicted an additional 2.5% of total frailty and 5.3% of physical frailty. The adverse effects of polymedication and its direct link with the amount of comorbidities could explain the independent contribution of this variable to frailty prediction. Furthermore, the consumption of drugs for cardiovascular diseases was particularly important for the prediction of frailty and of its physical domain. In the present study, a significant part of frailty was predicted, and the different contributions of each determinant to frailty domains provided additional evidence of the integral model of frailty’s relevance. The added value of a simple assessment of medication was considerable, and it should be taken into account for effective identification of frailty.