Self-reported exhaustion, physical activity, and grip strength predict frailty transitions in older outpatients with chronic diseases

Effective screening instruments are necessary for evaluating the outcomes of early interventions for the prevention or delay of disability in older persons. This study examined how transitions in frailty items over 1 year and the baseline components of a comprehensive geriatric assessment were associated with improvements in frailty at a 2-year follow-up in a sample of older patients. This was a single-center prospective observational study of older patients aged 65 years and over with chronic diseases (n=103), who were followed through a hospital-based program over 2 years. Frailty was evaluated via the modified Fried Frailty Index and a comprehensive geriatric assessment. We noted significant improvements in weight loss (P=.016) and self-reported exhaustion (P=.006), and a less decrease in grip strength (P=.009) at the 1-year follow-up. Furthermore, baseline cerebral vascular accident diagnosis (P=.022), high polypharmacy (P=.037), a higher Geriatric Depression Scale score (P=.033), and a lower Mini Nutritional Assessment score (P=.039) were significantly associated with improved frailty at the 2-year follow-up. Furthermore, improvement in self-reported exhaustion (odds ratio [OR]: 4.7, 1.4-16.1, P=.014) and physical activity (OR: 3.8, 1.0-13.7, P=.046), and a less decrease in grip strength (OR: 4.0, 1.3-12.5, P=.017) at the 1-year follow-up were significantly associated with improved frailty at the 2-year follow-up. Self-reported exhaustion, physical activity, and grip strength are easy, quick, and feasible screening tests for improvements in frailty in clinical practice.