Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin CohortReport as inadecuate

Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort - Download this document for free, or read online. Document in PDF available to download.

BMC Geriatrics

, 17:121

Physical functioning, physical health and activity


BackgroundThere is increasing demand for formal government funded home help services to support community-dwelling older people in Ireland, yet limited information exists on the health profiles of this group, especially regarding frailty. Our aim was to profile a large cohort of adults in receipt of low level home help and to determine the prevalence of frailty.

MethodsA total 1312 older adults, ≥ 65 years in receipt of low level home help < 5 h per week were reviewed by community nurses and frailty was assessed using the Clinical Frailty Scale CFS in this cross-sectional study. Characteristics of the group were compared between males and females and prevalence of frailty was reported according to gender and principal care. Associations between frailty and a number of variables were explored using bivariate and regression analysis.

ResultsThe cohort of low level home-help users was a mean age of 82.1 SD 7.3 years, predominantly female 70.6% and over half 69.2% lived alone. The prevalence of frailty in this population was 41.5%, with subjects primarily considered mildly 23.2% or moderately frail 14.5% by the CFS. A further 38.4% were classed as vulnerable. The degree of frailty did not differ significantly across the younger categories aged 65–84 years. However, in the oldest age groups, namely 90–94 and >95 years, moderate frailty was significantly higher relative to the younger groups 21% and 34%, p < 0.05, p < 0.01 respectively. Home help hours significantly correlated with frailty rs = 0.371, p < 0.001 and functional dependency rs = 0.609, p < 0.001, but only weakly with age rs = 0.101, p = 0.034. Based on regression analysis, determinants of frailty included greater dependency Barthel score, higher home help hours, non-self-caring and communication difficulty, all of which significantly contributed to the model, with a r squared value of 0.508.

ConclusionA high prevalence of frailty 41.5% was documented in this population which associated with higher home help utilisation. Frailty was associated with greater functional dependency, but not strongly with chronological age, until after 90 years. These findings highlight opportunities for developing intervention strategies targeted at ageing in place among home help users.

KeywordsFrailty Home help Domiciliary care Ageing Clinical frailty scale AbbreviationsADLActivities of Daily Living

CFSClinical Frailty Scale

CSARCommon Summary Assessment Report

HSEHealth Service Executive

PHNPublic health nurse

Electronic supplementary materialThe online version of this article doi:10.1186-s12877-017-0508-2 contains supplementary material, which is available to authorized users.

Author: Sara Kelly - Irene O’Brien - Karla Smuts - Maria O’Sullivan - Austin Warters



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