{"title":"Frailty reversal and its main determinants: a population-based observational and longitudinal study.","authors":"Mateu Serra-Prat, Aida Fortuny Borsot, Emili Burdoy, Àngel Lavado Cuevas, Laura Muñoz Ortiz, Mateu Cabré","doi":"10.1136/fmch-2024-003250","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Clinical guidelines recommend frailty screening for the aged population, given that frailty is frequently reversible. However, little is known about frailty and prefrailty reversal rates in the general population if no specific interventions have been implemented.</p><p><strong>Aim: </strong>To assess real-world frailty and prefrailty reversal rates in the general population aged ≥65 years, the main contributing clinical conditions and the main risk factors for reversing frailty and prefrailty.</p><p><strong>Methods: </strong>Observational longitudinal 12-month study (2019) of all 1·5 million persons aged ≥65 years in Catalonia. Data were retrospectively collected from various health databases through the Catalan Public Data Analysis for Health Research and Innovation (PADRIS) V.2022 programme. Frailty status according to the electronic Screening Index for Frailty (e-SIF) was determined for 31 December 2018 and for 31 December 2019.</p><p><strong>Results: </strong>The study included 1 465 312 Catalan inhabitants (mean age 75.8 years, 57.0% women). The annual frailty and pre-frailty reversal rates were 7.1% and 4.6%, respectively. Both rates were higher in men and decreased with age. The e-SIF components with the greatest impact on frailty reversal were non-planned hospitalisations, polypharmacy, orthostatic hypotension or syncope, anaemia and visual impairment. Female sex, age, dependency, ≥2 comorbidities and polypharmacy had an independent protective effect on 12-month frailty and pre-frailty reversals.</p><p><strong>Conclusions: </strong>Prefrailty and frailty are reversible, but reversal is unlikely in cases of multimorbidity, polypharmacy and functional dependency in older and severely frail individuals. Interventions that mainly target the avoidance of non-planned hospitalisations, polypharmacy and falls would have the greatest impact on reversing frailty and pre-frailty.</p>","PeriodicalId":44590,"journal":{"name":"Family Medicine and Community Health","volume":"13 2","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039016/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Family Medicine and Community Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/fmch-2024-003250","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
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Abstract
Background: Clinical guidelines recommend frailty screening for the aged population, given that frailty is frequently reversible. However, little is known about frailty and prefrailty reversal rates in the general population if no specific interventions have been implemented.
Aim: To assess real-world frailty and prefrailty reversal rates in the general population aged ≥65 years, the main contributing clinical conditions and the main risk factors for reversing frailty and prefrailty.
Methods: Observational longitudinal 12-month study (2019) of all 1·5 million persons aged ≥65 years in Catalonia. Data were retrospectively collected from various health databases through the Catalan Public Data Analysis for Health Research and Innovation (PADRIS) V.2022 programme. Frailty status according to the electronic Screening Index for Frailty (e-SIF) was determined for 31 December 2018 and for 31 December 2019.
Results: The study included 1 465 312 Catalan inhabitants (mean age 75.8 years, 57.0% women). The annual frailty and pre-frailty reversal rates were 7.1% and 4.6%, respectively. Both rates were higher in men and decreased with age. The e-SIF components with the greatest impact on frailty reversal were non-planned hospitalisations, polypharmacy, orthostatic hypotension or syncope, anaemia and visual impairment. Female sex, age, dependency, ≥2 comorbidities and polypharmacy had an independent protective effect on 12-month frailty and pre-frailty reversals.
Conclusions: Prefrailty and frailty are reversible, but reversal is unlikely in cases of multimorbidity, polypharmacy and functional dependency in older and severely frail individuals. Interventions that mainly target the avoidance of non-planned hospitalisations, polypharmacy and falls would have the greatest impact on reversing frailty and pre-frailty.
期刊介绍：
Family Medicine and Community Health (FMCH) is a peer-reviewed, open-access journal focusing on the topics of family medicine, general practice and community health. FMCH strives to be a leading international journal that promotes ‘Health Care for All’ through disseminating novel knowledge and best practices in primary care, family medicine, and community health. FMCH publishes original research, review, methodology, commentary, reflection, and case-study from the lens of population health. FMCH’s Asian Focus section features reports of family medicine development in the Asia-pacific region. FMCH aims to be an exemplary forum for the timely communication of medical knowledge and skills with the goal of promoting improved health care through the practice of family and community-based medicine globally. FMCH aims to serve a diverse audience including researchers, educators, policymakers and leaders of family medicine and community health. We also aim to provide content relevant for researchers working on population health, epidemiology, public policy, disease control and management, preventative medicine and disease burden. FMCH does not impose any article processing charges (APC) or submission charges.
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