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Observational Study
. 2019 Jun 21;9(6):e027768.
doi: 10.1136/bmjopen-2018-027768.

Prevalence of frailty in older adults in outpatient physiotherapy in an urban region in the western part of Germany: a cross-sectional study

Tobias Braun  1 , Christian Thiel  1   2 , Carina Ziller  1 , Julia Rasche  1 , Carolin Bahns  1 , Lisa Happe  1 , Theresa Retzmann  1 , Christian Grüneberg  1
Affiliations
Observational Study

Prevalence of frailty in older adults in outpatient physiotherapy in an urban region in the western part of Germany: a cross-sectional study

Tobias Braun et al. BMJ Open. .

Abstract

Objective: To investigate the prevalence of frailty in older people in outpatient physiotherapy services in an urban region in the western part of Germany.

Design: Cross-sectional study.

Setting: Outpatient physiotherapy clinics were recruited in the municipal area of the city of Bochum, Germany, and selected randomly.

Participants: Older adults aged 65 years and older seeking outpatient physiotherapy.

Primary and secondary outcome measures: Prevalence of frailty was assessed based on the frailty phenotype model of physical frailty and the accumulation of deficit model, expressed as a Frailty Index. Prevalence was calculated for the whole sample and according to age-related, sex-related and diagnosis-related subgroups.

Results: A total of 258 participants (74±6 years, 62% female) from 11 out of 130 (8%) different physiotherapy clinics were included. Participants' main indication for physiotherapy was an orthopaedic or surgical condition (75%). According to the model of a physical frailty phenotype, 17.8% (95% CI 13.2 to 22.5) participants were frail and 43.4% (95% CI 37.4 to 49.5) were prefrail. The Frailty Index identified 31.0% (95% CI 25.4 to 36.7) of individuals as frail. In both models, prevalence increased with age and was higher in women than in men. Slow gait speed (34%), reduced muscle strength (34%) and exhaustion (28%) were the most prevalent indicators of physical frailty.

Conclusions: Frailty is comparatively common in older patients attending physiotherapy care in Germany, with one out of three individuals being frail and every second individual being physically frail or prefrail.

Trial registration number: DRKS00009384; Results.

Keywords: aged; epidemiology; frail older adults; frailty index; frailty phenotype; prevalence.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow of outpatient physiotherapy clinics and participants through the study.
Figure 2
Figure 2
The prevalence of physical frailty (Fried’s model of a physical frailty phenotype) with 95% CIs for the complete sample and according to groups for sex, age and physiotherapy indication.
Figure 3
Figure 3
The prevalence of frailty (Frailty Index/model of deficit accumulation) with 95% CIs for the complete sample and according to groups for sex, age and physiotherapy indication.
Figure 4
Figure 4
Frequency of physical frailty phenotype deficits in the subgroups of participants.
See this image and copyright information in PMC

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References

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