Prevalence of frailty in older people in Veneto (Italy)*

Abstract

Context: Both frailty and multimorbidity are strong predictors of clinical endpoints for older people. In Italy, the interventions targeting chronicity are mainly based on the treatment of diseases: sufficient epidemiological literature is available about these strategies. Less is known about the territorial distribution of the frailty status.

Aims: To estimate the prevalence of frailty in older people (65+) and to evaluate the relationship between frailty and multimorbidity.

Methods and material: A group of general practitioners working in Veneto (Italy) was enrolled on a voluntary basis. Older individuals were both community dwelling and institutionalized patients, that is, the older people normally followed by Italian general practitioners. A centrally randomized sample was extracted from the pool of physician-assisted elderly. Each doctor evaluated the frailty status through the CSHA Clinical Frailty Scale and the multimorbidity status through the Charlson score (Frailty = CSHA Clinical Frailty Scale’s score >4; serious multimorbidity = Charlson score ≥4). Prevalence and its confidence interval (CI) 95% were evaluated through the Agresti’s method for proportions. The relation between frailty and multimorbidity was studied through a logistic regression model adjusted for age and sex.

Results: Fifty-three physicians were enrolled, whose population of elderly individuals (N = 82919) was highly representative of the population of Veneto. The prevalence of frailty in the randomized sample of 2407 older people was 23.18% (CI 95%: 21.53%–24.91%). Sex was shown to be a strong predictor of frailty (female status OR = 1.58 p < .0001) and multimorbidity was shown to be an independent predictor only for individuals <85 years of age.

Conclusions: In Veneto, more than 20% of elderly people are frail. Physicians should pay close attention to frailty and multimorbidity because both are important prognostic factors toward clinical endpoints relevant to territorial care. The CSHA Clinical Frailty Scale (easy and quick) should become part of their professional routine.

Keywords:

• Elderly
• Rockwood Clinical Frailty Scale
• frailty
• Charlson score
• multimorbidity
• cross-sectional design
• prevalence

Transparency

Declaration of funding

There is no funding to declare for this study.

Declaration of financial/other relationships

The authors have no financial or other relationships to disclose. JDA peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

We thank the following general practitioners for actively participating as researchers of the Veneto Study Group on the Elderly:

Pirolo Giulio, Balzan Corrado, Barilla Giuseppe, Buzzatti Agostino, Cassol Maria Antonia, Mazzorana Michela, Scarrocchia Luisa, Zollino Maria Luciana, Cabri Giovanni, Dolci Alberto, Tonello Paolo, Franchini Carlo Andrea, Fracasso Isabella, Casalena Michele, Dima Catia, Givanni Silvana, Marrocchella Raffaella, Menini Ernesto, Micchi Alessio, Pastori Caterina, Sciortino Maurizio, Cancian Maurizio, De Conto Umberto, Antiga Gianluigi, Camarotto Antonio, Camerotto Antonio, Dalla Zentil Giovanni, Mulato Giuseppe, Pantaleoni Nicola, Peccolo Franco, Penco Claudio, Pieropan Franco, Pregnolato Umberto, Redetti Marina, Zorgno Nadia, Musto Martina, Michieli Raffaella, Bergamasco Giulio, Blundetto Emanuela, De Zan Antonio, Moressa Maria Pia, Ongaro Andrea, Severi Sandro, Spinardi Francesco, Franco Novelletto Bruno, Bordin Anna, De Gobbi Riccardo, Fanton Livio, Fraccaro Bianca Maria, Franzoso Federico, Merola Gennaro, Bordin Anna, Simioni Giuliana

Acknowledgements

We are grateful to the following people for the important contribution of recruiting researchers:

Musto Martina, Carraro Alessandro, Pirolo Giulio, Ioverno Enrico, Franchini C Andrea, De Conto Umberto.