PMID- 34725670
OWN - NLM
STAT- MEDLINE
DCOM- 20220317
LR  - 20240317
IS  - 1760-4788 (Electronic)
IS  - 1279-7707 (Linking)
VI  - 25
IP  - 9
DP  - 2021
TI  - Disentangling the Relationship between Frailty and Intrinsic Capacity in Healthy 
      Community-Dwelling Older Adults: A Cluster Analysis.
PG  - 1112-1118
LID - 10.1007/s12603-021-1679-2 [doi]
AB  - BACKGROUND: Frailty and intrinsic capacity (IC) are distinct but interrelated 
      constructs. Uncertainty remains regarding how they are related and interact to 
      influence health outcomes. We aim to understand the relationship between frailty 
      and IC by identifying subgroups based on frailty criteria and IC domains and 
      studying one-year outcomes. METHODS: We studied 200 independent 
      community-dwelling older adults (mean age 67.9+/-7.9 years, Modified Barthel Index 
      (MBI) score 99+/-2.6). Frailty was defined by modified Fried criteria. Scores 
      (range: 0-2) were assigned to individual IC domains (cognition, psychological, 
      locomotion, and vitality) to yield a total IC score of 8. To identify subgroups, 
      two-step cluster analysis was performed with age, frailty and IC domains. Cluster 
      associations with one-year outcomes (frailty, muscle strength (grip strength, 
      repeated chair stand test), physical performance (gait speed, Short Physical 
      Performance Battery), function (MBI) and quality-of-life (EuroQol (EQ)-5D)) were 
      examined using multiple linear regression adjusted for age, gender and education. 
      RESULTS: Three distinct clusters were identified - Cluster 1: High IC/Robust 
      (N=74, 37%); Cluster 2: Intermediate IC/Prefrail (N=73, 36.5%); and Cluster 3: 
      Low IC/Prefrail-Frail (53, 26.5%). Comparing between clusters, IC domains, 
      cognition, depressive symptoms, nutrition, strength and physical performance were 
      least impaired in Cluster 1, intermediate in Cluster 2 and most impaired in 
      Cluster 3. At one year, the proportion transitioning to frailty or remaining 
      frail was highest in Cluster 3 compared to Cluster 2 and Cluster 1 (39% vs 6.9% 
      vs 2.8%, P<0.001). Compared to Cluster 1, Cluster 3 experienced greatest declines 
      in grip strength (beta=-4.1, P<.001), MBI (beta=-1.24, P=0.045) and EQ-5D utility 
      scores (beta=-0.053, P=0.005), with Cluster 2 intermediate between Cluster 1 and 
      Cluster 3. CONCLUSIONS: Amongst independent community-dwelling older adults, IC 
      is complementary to frailty measures through better risk-profiling of one-year 
      outcomes amongst prefrail individuals into intermediate and high-risk groups. The 
      intermediate group merits follow-up to ascertain longer-term prognosis.
FAU - Chew, J
AU  - Chew J
AD  - Justin Chew, Tan Tock Seng Hospital, Singapore, justin_chew@ttsh.com.sg.
FAU - Lim, J P
AU  - Lim JP
FAU - Yew, S
AU  - Yew S
FAU - Yeo, A
AU  - Yeo A
FAU - Ismail, N H
AU  - Ismail NH
FAU - Ding, Y Y
AU  - Ding YY
FAU - Lim, W S
AU  - Lim WS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - France
TA  - J Nutr Health Aging
JT  - The journal of nutrition, health & aging
JID - 100893366
SB  - IM
MH  - Aged
MH  - Cluster Analysis
MH  - Frail Elderly/psychology
MH  - *Frailty/diagnosis
MH  - Geriatric Assessment
MH  - Hand Strength/physiology
MH  - Humans
MH  - Independent Living
OTO - NOTNLM
OT  - Intrinsic capacity
OT  - cluster analysis
OT  - frailty
OT  - healthy ageing
OT  - outcomes
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/11/03 06:00
MHDA- 2022/03/18 06:00
CRDT- 2021/11/02 06:19
PHST- 2021/11/02 06:19 [entrez]
PHST- 2021/11/03 06:00 [pubmed]
PHST- 2022/03/18 06:00 [medline]
AID - S1279-7707(23)00767-4 [pii]
AID - 10.1007/s12603-021-1679-2 [doi]
PST - ppublish
SO  - J Nutr Health Aging. 2021;25(9):1112-1118. doi: 10.1007/s12603-021-1679-2.