The prevalence of frailty and its relation to other geriatric syndromes in the oldest old age: from Turkey's second oldest populated region

Aims: Geriatric syndromes may cause unfavorable outcomes in old age population and the prevalence of geriatric syndromes varies in oldest old age group. The influence of gender and other geriatric syndromes on these variation in the oldest old remains unclear. This study aims to investigate the prevalence of geriatric syndromes and the factors that influence frailty in oldest old. Methods: This study was conducted retrospectively by using records of non-bedridden patients aged 80 years and over obtained through home visits carried out by the geriatric unit. Frailty was assessed via the Clinical Frailty Scale, with scores of 4 or higher indicating frailty. Depression was evaluated using the Yesavage Geriatric Depression Scale, and undernutrition was diagnosed using the Mini Nutritional Assessment. Physical performance was evaluated using the Five Times Sit-to-Stand Test (STS) and Time Up Go (TUG) Test. Activities of daily living (ADL) and instrumental activities of daily living (IADL) were assessed. Results: The mean age of the study population was 85.48±4.4, %21.2 were nonagenarian and 64% were female patients. Frailty was detected in 70% of the patients, depression in 59.9%, and malnutrition in 30%. Nonagenarians were significantly more frail compared to octogenarians (p=0.010) and more failure on TUG test (p= 0.009), while there was no significant difference between the two groups in terms of depression and undernutrition (p=0.693, p=0.133, respectively). The prevalence of frailty in women was significantly higher compared to men (p=<0.001). Similarly, females showed significantly poorer performance in the ADL, IADL, TUG and STS (p = 0.016, p = 0.026, p < 0.001, p = 0.001, respectively). In the univariate regression analyses, female gender, depression, undernutrition, and the presence of dementia increased the risk of frailty significantly by 3.1, 2.56, 5.86 and 2.73 times (p= <0.001, p=0.003, p<0.001, p=0.015, respectively). Conclusion: The prevalence of frailty and depression is markedly elevated in the oldest old age group. Furthermore, women reach advanced ages more frequently and experience increased frailty compare to men. Considering the adverse outcomes that frailty can cause in oldest old, it is critical for clinicians to be attentive to modifiable factors such as depression and malnutrition.