Associations between frailty trajectories and frailty status in community-dwelling older adults: a two-year follow-up study

Frailty increases the risk of functional dependence and health-related consequences. This study intends to determine the needs of frailty at-risk in the community, a growing priority for intervention and policymakers. A prospective cohort study was conducted between 2018 and 2020 at a medical center in Taipei, Taiwan. Older adults and those admitted to the annual health examinations were invited. Frailty was assessed using Fried’s criteria, self-reported questionnaires, and objective measures at baseline, 6, 12, and 24 months after baseline. Frailty trajectories were modeled using group-based trajectory analysis. The final analytic sample included 318 participants. The recognized trajectory groups of older Taiwanese adults were classified as the Maintaining Nonfrailty group (28.6%), the Slowly Developing Frailty group (52.2%), and the Rapidly Developing Frailty group (19.2%). After gender, age, marital status, and domains of frailty were added to the group-based trajectory model, compared with the Maintaining Nonfrailty group, weakness (grip strength) was the only factor related to both the slowly and rapidly developing frailty group (B = 3.95, p < 0.001; B = 2.30, p < 0.01, respectively). The significant factor associated with the Slowly Developing Frailty group was high school education (OR = 2.09, 95% CI = 1.45-3.00). Less than high school education (OR = 4.27, 95% CI = 2.33–7.81), living alone (OR = 2.52, 95% CI = 1.43–4.42), and exposure to polypharmacy treatment (OR = 3.80, 95% CI = 1.89–7.64) were the significant determinants of the Rapidly Developing Frailty group. Preventing polypharmacy may delay frailty. We recommend that strategies for deprescribing decisions and include grip strength changes in public health policy as assessment items to allow early detection of frailty, especially rapidly developing frailty in the future. This study intends to determine the needs of frailty at-risk in the community, a growing priority for intervention and policymakers. Grip strength is related to the slowly and rapidly developing frailty groups. High school education was a significant factor associated with the Slowly Developing Frailty group. Less than high school education, living alone, and exposure to polypharmacy treatment were the significant determinants of the Rapidly Developing Frailty group. Understanding that includes deprescribing strategies and grip strength change in public health policy for early frailty detection, especially rapidly developing frailty in the future.