Multimorbidity and Depression Increase Prevalence of Frailty of Community-dwelling Indonesian Older Adults: Indonesia Care Networks Study

Yvonne Suzy Handajani, Elisabeth SchroederButterfill, Eef Hogervorst, Yuda Turana, Antoninus Hengky

Abstract


Background: Older adults with frailty have an increased risk of multiple negative health outcomes, such as disability, falls, and morbidity when exposed to physical stressors. The present study investigated the prevalence of frailty and associated risk factors among community‑dwelling Indonesian older adults in several districts in Jakarta, Indonesia. Methods: This cross‑sectional study was done in several urban villages in Jakarta, Indonesia. It involved community‑dwelling Indonesian older adults aged 60 and over. Sociodemographic and multiple health data were assessed and measured by a trained interviewer. Frailty was evaluated using Fried’s criteria. Results: The data analysis found a 14.7% prevalence of frailty among 518 participants. Multivariate analysis showed that frailty was independently associated with females (OR 3.62, 95% CI: 1.73–7.55), having multimorbidity (OR 2.01, 95% CI: 1.21–3.35), and clinical depression (OR 2.13, 95% CI: 1.24–3.65). Conclusions: Early interventions in younger older adults, especially women in their early 50s or 60s, might decrease frailty risk over age 60. Controlling chronic disease and better mental education and support to reduce depression risk could reduce frailty risk.

Keywords


Depression, frailty; Indonesia; multimorbidity; older adults; risk factors

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References


Alqahtani BA, Alenazi AM, Alshehri MM, Osailan AM, Alsubaie SF, Alqahtani MA. Prevalence of frailty and associated factors among Saudi community dwelling older adults: A cross sectional study. BMC Geriatr 2021;21:185.

Ye L, Elstgeest LEM, Zhang X, Alhambra Borrás T, Tan SS, Raat H. Factors associated with physical, psychological and social frailty among community dwelling older persons in Europe: A cross sectional study of Urban Health Centres Europe (UHCE). BMC Geriatr 2021;21:422.

O’Caoimh R, Sezgin D, O’Donovan MR, Molloy DW, Clegg A, Rockwood K, et al. Prevalence of frailty in 62 countries across the world: A systematic review and meta analysis of population level studies. Age Ageing 2021;50:96–104.

United Nations [UN] Department of Economic and Social Affairs, Population Division. World Population Ageing 2020 Highlights: Living arrangements of older persons. New York, US: United Nations Publications; 2020.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adultsevidence for a phenotype. J Gerontol Ser A Biol Sci Med Sci 2001;56:M146–57.

Navarrete Villanueva D, Gómez Cabello A, Marín Puyalto J, Moreno LA, Vicente Rodríguez G, Casajús JA. Frailty and physical fitness in elderly people: A systematic review and meta analysis. Sport Med 2020;51:143–60.

Siviero P, Limongi F, Noale M, Della Dora F, Martini A, Castiglione A, et al.; Alvise Cornaro Center Study Group. The prevalence of frailty and its associated factors in an Italian institutionalized older population: Findings from the cross sectional Alvise Cornaro Center Study. Aging Clin Exp Res 2021;1:1103–12.

Wang Y, Han HR, Yang W, Zhang H, Zhang J, Ruan H, et al. Associations between risk factors for cardiovascular diseases and frailty among community dwelling older adults in Lanzhou, China. Int J Nurs Sci 2021;8:168–74.

Buttery AK, Busch MA, Gaertner B, Scheidt Nave C, Fuchs J. Prevalence and correlates of frailty among older adults: Findings from the German health interview and examination survey. BMC Geriatr 2015;15:22.

Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: A multilevel analysis. BMC Geriatr 2018;18:314.

Setiati S, Soejono CH, Harimurti K, Dwimartutie N, Aryana IGPS, Sunarti S, et al. Frailty and its associated risk factors: First phase analysis of multicentre Indonesia longitudinal aging study. Front Med (Lausanne) 2021;8:658580.

Rizka A, Indrarespati A, Dwimartutie N, Muhadi M. Frailty among older adults living in nursing homes in Indonesia: Prevalence and associated factors. Ann Geriatr Med Res 2021;25:93 7.

Nishida C, Barba C, Cavalli Sforza T, Cutter I, Darnton Hill P, Deurenberg M, et al. Appropriate body mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157–63.

Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for Depression in well older adults: Evaluation of a short form of the CES D. Am J Prev Med 1994;10:77–84.

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12 Country reliability and validity. Med Sci Sport Exerc 2003;35:1381–95.

Indawati R, Kuntoro, Notobroto HB, Qomaruddin MB, Mahujudin MS, Asiyah SN. Screening performance of the geriatric depression scale (GDS 15) for elderly in the community, Indonesia. Int J Res Advent Technol 2016;4:11 4.

Indrajaya AW, Lumempouw SF, Ramli Y, Prihartono J. Normative value of CERAD neuropsychology examination in Jakarta. Neurona 2013;30:3.

World Health Organization [WHO]. Multimorbidity. Geneva: WHO; 2016. Available from: https://apps.who.int/iris/ handle/10665/252275.

Shin C, Park MH, Lee SH, Ko YH, Kim YK, Han KM, et al. Usefulness of the 15 item geriatric depression scale (GDS 15) for classifying minor and major depressive disorders among community dwelling elders. J Affect Disord 2019;259:370–5.

Sainsbury A, Seebass G, Bansal A, Young JB. Reliability of the Barthel Index when used with older people. Age Ageing 2005;34:228–32.

Hogervorst E, Mersjid F, Ismail RI, Prasetyo S, Nasrun M, Mochtar, et al. Validation of two short dementia screening tests in Indonesia. In: Jacobsen SR, editor. Vascular Dementia: Risk Factors, Diagnosis and Treatment. New York, US: Nova Science Publishers; 2011. p. 13.

He B, Ma Y, Wang C, Jiang M, Geng C, Chang X, et al. Prevalence and risk factors for frailty among community dwelling older people in China: A systematic review and meta analysis. J Nutr Heal Aging 2019;23:442–50.

Thompson MQ, Theou O, Adams RJ, Tucker GR, Visvanathan R. Frailty state transitions and associated factors in South Australian older adults. Geriatr Gerontol Int 2018;18:1549–55.

Hubbard RE. Sex differences in frailty. Interdiscip Top Gerontol Geriatr 2015;41:41–53.

Min KJ, Lee CK, Park HN. The lifespan of Korean eunuchs. Curr Biol 2012;22:R792–3.

Sapienza P, Zingales L, Maestripieri D. Gender differences in financial risk aversion and career choices are affected by testosterone. Proc Natl Acad Sci USA 2009;106:15268–73.

Gordon EH, Peel NM, Samanta M, Theou O, Howlett SE, Hubbard RE, et al. Sex differences in frailty: A systematic review and meta analysis. Exp Gerontol 2017;89:30–40.

Vetrano DL, Palmer K, Marengoni A, Marzetti E, Lattanzio F, Roller Wirnsberger R, et al.; Joint Action ADVANTAGE WP4 Group. Frailty and multimorbidity: A systematic review and meta analysis. J Gerontol Ser A Biol Sci Med Sci 2019;74:659–66.

Marengoni A, Angleman S, Meinow B, Santoni G, Mangialasche F, Rizzuto D, et al. Coexisting chronic conditions in the older population: Variation by health indicators. Eur J Intern Med 2016;31:29–34.

Villacampa Fernández P, Navarro Pardo E, Tarín JJ, Cano A. Frailty and multimorbidity: Two related yet different concepts. Maturitas 2017;95:31–5.

Huang CY, Lee WJ, Lin HP, Chen RC, Lin CH, Peng LN, et al. Epidemiology of frailty and associated factors among older adults living in rural communities in Taiwan. Arch Gerontol Geriatr 2020;87:103986.

Singh M, Alexander K, Roger VL, Rihal CS, Whitson HE, Lerman A, et al. Frailty and its potential relevance to cardiovascular care. Mayo Clin Proc 2008;83:1146–53.

Vorst VA, Veld LPM, Witte N, Schols JMGA, Kempen GIJM, Zijlstra GAR. The impact of multidimensional frailty on dependency in activities of daily living and the moderating effects of protective factors. Arch Gerontol Geriatr 2018;78:255–60.

Lee Y, Kim J, Han ES, Ryu M, Cho Y, Chae S. Frailty and body mass index as predictors of 3 year mortality in older adults living in the community. Gerontology 2014;60:475–82.

Watanabe D, Yoshida T, Watanabe Y, Yamada Y, Kimura M, Kyoto Kameoka Study Group. A U shaped relationship between the prevalence of frailty and body mass index in community dwelling japanese older adults: The Kyoto–Kameoka Study. J Clin Med 2020;9:1367.

Yuan L, Chang M, Wang J. Abdominal obesity, body mass index and the risk of frailty in community dwelling older adults: A systematic review and meta analysis. Age Ageing 2021;50:1118–28.

Sargent L, Nalls M, Starkweather A, Hobgood S, Thompson H, Amella EJ, et al. Shared biological pathways for frailty and cognitive impairment: A systematic review. Ageing Res Rev 2018;47:149.

Furtado GE, Letieri R, Hogervorst E, Teixeira AB, Ferreira JP. Physical frailty and cognitive performance in older populations, Part I: Systematic review with meta analysis. Cienc e Saude Coletiva 2019;24:203–18.

Canevelli M, Cesari M, Van Kan GA. Frailty and cognitive decline: How do they relate? Curr Opin Clin Nutr Metab Care 2015;18:43–50.

Lee Y, Kim J, Chon D, Lee KE, Kim JH, Myeong S, et al. The effects of frailty and cognitive impairment on 3 year mortality in older adults. Maturitas 2018;107:50–5.

Vaughan L, Corbin AL, Goveas JS. Depression and frailty in later life: A systematic review. Clin Interv Aging 2015;10:1947.

Woods NF, LaCroix AZ, Gray SL, Aragaki A, Cochrane BB, Brunner RL, et al. Frailty: Emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2005;53:1321–30.