Prevalence of Frailty and Its Association with Health Conditions among Community-Dwelling Older Adults with Knee Osteoarthritis
DOI:
https://doi.org/10.60099/jtnmc.v39i04.269057Keywords:
frailty, knee osteoarthritis, life-space mobility, limited physical function, older adultsAbstract
Introduction Frailty is a common health issue in older adults, arising from age-related declines in body reserves and the impairment of various physiological systems due to inflammation. Older adults suffering from knee osteoarthritis experience an increased risk of frailty. As the disease progresses, inflammation-induced knee pain can emerge, resulting in limited mobility and balance. This increases the risk of falls, decreased physical function, limited life-space mobility, and ultimately disability.
Objective To explore the prevalence of frailty and examine the association between frailty and health conditions (falls, limited physical function, and life-space mobility) among community-dwelling older adults with knee osteoarthritis
Design A cross-sectional correlational study
Methodology The participants comprised 210 community-dwelling older adults aged 60 years and older diagnosed with knee osteoarthritis and/or showed clinical symptoms of knee osteoarthritis and living in the health service areas of the three health-promoting hospitals in Nakhonphanom province. The participants were recruited through multi-stage random sampling. Sample size was determined based on power analysis. Data were collected from February to November 2022 and involved interviews using the following instruments: Demographic and Health Information Questionnaire, Reported Edmonton Frail Scale-Thai version (REFS), Knee Osteoarthritis Outcome Score (KOOS-ADL), and University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA). The descriptive statistics and Spearman’s rank correlation coefficients were used for data analysis.
Results Most participants were female (69.0%), with an average age of 69.49 years (SD = 7.23). Over half reported health problems (54.3%), primarily hypertension. The median score for osteoarthritis symptoms was 5, while the average severity of knee pain was 4.51 (SD = 1.75). The prevalence of frailty in the study participants was 33.8%. Frailty was positively associated with health conditions, including falls (r = .265, p < .001) and limited physical function (r = .415, p < .001), while negatively associated with life-space mobility (r = -.284, p < .001).
Recommendation Findings from this study indicate that frailty is common among older adults with knee osteoarthritis and is related to health conditions. Healthcare professionals should be aware of early screening for frailty in this population. Planning for interventions to promote health may result in delaying dependency and preventing adverse health consequences in older adults with knee osteoarthritis.
Downloads
References
Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. E Clinical Medicine. 2020;29-30:100587. https://doi.org/10.1016/j.eclinm.2020.100587 PMID: 34505846
Primorac D, Molnar V, Rod E, Jelec Z, Cukelj F, Matisic V, et al. Knee osteoarthritis: a review of pathogenesis and state-of-the-art non-operative therapeutic considerations. Genes (Basel). 2020;11(8):854. https://doi.org/10.3390/genes11080854 PMID: 32722615
Mat S, Kamaruzzaman SB, Chin AV, Tan MP. Impact of knee pain on fear of falling, changes in instrumental activities of daily living, and falls among Malaysians age 55 years and above. Front Public Health. 2020;8: 571196. https://doi.org/10.3389/fpubh.2020.571196 PMID: 33163471
Huang G, Qian D, Liu Y, Qu G, Qian Y, Pei B. The association between frailty and osteoarthritis based on the NHANES and mendelian randomization study. Arch Med Sci. 2023;19(5):1545-50. https://doi.org/10.5114/aoms/171270 PMID: 37732065
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3):146-56. https://doi.org/10.1093/gerona/56.3.m146 PMID: 11253156
Wanaratna K, Muangpaisan W, Kuptniratsaikul V, Chalermsri C, Nuttamonwarakul A. Prevalence and factors associated with frailty and cognitive frailty among community-dwelling elderly with knee osteoarthritis. J Community Health. 2019;44(3): 587-95. https://doi.org/10.1007/s10900-018-00614-5 PMID: 30604223.
Soh SE, Barker AL, Morello RT, Ackerman IN. Applying the International Classification of Functioning, Disability and Health framework to determine the predictors of falls and fractures in people with osteoarthritis or at high risk of developing osteoarthritis: data from the osteoarthritis initiative. BMC Musculoskelet Disord. 2020;21(1):138. https://doi.org/10.1186/s12891-020-3160-5 PMID: 32113478
Marks R. Osteoarthritis and frailty: associations, relevance, and counter solutions. J Aging Res and Health. 2022;4(2):14-30. https://doi.org/10.14302/issn.2474-7785.jarh-22-4070
Tkacheva ON, Runikhina NK, Merkusheva NI, Lysenkov SN, Ostapenko VS, Sharashkina NV, et al. The association between comorbidity, frailty, and outdoor mobility loss among community-dwelling individuals 60 years of age and above in Moscow. Rejuvenation Res. 2021;24(2):151–7. https://doi.org/10.1089/rej.2019.2289
Saraboon Y, Aree-ue Y, Jarupat-Maruo S. Symptoms, knowledge, and perceived illness representation related to knee osteoarthritis among elderly in a community: a pilot study. Journal of Boromarajonani College of Nursing, Bangkok. 2014;30(2);12-24. (in Thai)
Peungsuwan P, Chatchawan U, Puntumetakul R, Yamauchi J. The prevalence and work-related physical factors associated with knee pain in older Thai farmers. J Phys Ther Sci. 2019;31(6):466-9. https://doi.org/10.1589/jpts.6.466
Thessingha C, Chaiwong C, Onthaisong C, Intolo S. The prevalence and risk factors of knee osteoarthritis among the elderly in Northeast Thailand. Journal of Boromrajonani College of Nursing, Surin. 2020; 10(1):80-9. Available from https://he01.tci-thaijo.org/index.php/bcnsurin/article/view/206104 (in Thai)
World Health Organization. International classification of functioning, disability, and health (ICF) [Internet]. 2001 [cited 2024 Mar 10]. Available from: https://apps.who.int/iris/handle/10665/42407
Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum. 1986; 29(8):1039-49. https://doi.org/10.1002/art.1780290816 PMID: 3741515
Aree-Ue S, Youngcharoen P. The 6 items cognitive function test-Thai version: psychometric property testing. Ramathibodi Nursing Journal. 2020;26(2): 188-202. (in Thai)
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2):175–91. https://doi.org/10.3758/bf03193146 PMID: 17695343
Shaw BH, Borrel D, Sabbaghan K, Kum C, Yang Y, Robinovitch SN, et al. Relationships between orthostatic hypotension, frailty, falling and mortality in elderly care home residents. BMC Geriatr. 2019;19(1):80. https://doi.org/10.1186/s12877-019-1082-6
Brooke P, Bullock R. Validation of a 6 items cognitive impairment test with a view to primary care usage. Int J Geriatr Psychiatry. 1999;14(11):936–40.
Hilmer SN, Perera V, Mitchell S, Murnion BP, Dent J, Bajorek B, et al. The assessment of frailty in older people in acute care. Australas J Ageing. 2009;28(4):182-8. https://doi.org/10.1111/j.1741-6612.2009.00367.x
Roopsawang I, Thompson H, Zaslavsky O, Belza B. The Reported Edmonton Frail Scale-Thai version: development and validation of a culturally-sensitive instrument. Nurs Health Sci. 2020;22(3):685-93. https://doi.org/10.1111/nhs.12713
Baker PS, Bodner EV, Allman RM. Measuring life-space mobility in community-dwelling older adults. J Am Geriatr Soc. 2003;51(11):1610–4. https://doi.org/10.1046/j.1532-5415.2003.51512.x
Aree-Ue S, Roopsawang I, Chintapanyakun T, Saraboon Y, Intharakasem S, Kawinwonggowit V. Monitoring changes in health dimensions among Thai older persons prior to covid-19 pandemic, during the pandemic, and new normal [Internet]. 2022 [cited 2024 Mar 10]. Available from: https://kb.hsri.or.th/dspace/bitstream/handle/11228/5488/hs2754.pdf?sequence=3&isAllowed=y (in Thai)
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)-development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88-96. https://doi.org/10.2519/jospt.1998.28.2.88
Chaipinyo K. Test-retest reliability and construct validity of the Thai version of knee osteoarthritis outcome scores (KOOS). Thai Journal of Physical Therapy. 2009; 31(2):67–76. (in Thai)
Salaffi F, Di Carlo M, Carotti M, Farah S, Giovagnoni A. Frailty prevalence according to the Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI) definition, and its variables associated, in patients with symptomatic knee osteoarthritis: findings from a cross-sectional study. Aging Clin Exp Res. 2021;33(6):1519-27. https://doi.org/10.1007/s40520-020-01667-0
Fried LP, Cohen AA, Xue QL, Walston J, Bandeen- Roche K, Varadhan R. The physical frailty syndrome as a transition from homeostatic symphony to cacophony. Nat Aging. 2021;1(1):36-46. https://doi.org/10.1038/s43587-020-00017-z PMID: 34476409
Jung H, Kim M, Lee Y, Won CW. Prevalence of physical frailty and its multidimensional risk factors in Korean community-dwelling older adults: findings from Korean frailty and aging cohort study. Int J Environ Res Public Health. 2020;17(21):7883. https://doi.org/10.3390/ijerph17217883
Nakai Y, Makizako H, Kiyama R, Tomioka K, Taniguchi Y, Kubozono T, et al. Association between chronic pain and physical frailty in community-dwelling older adults. Int J Environ Res Public Health. 2019;16(8): 1330. https://doi.org/10.3390/ijerph16081330 PMID: 31013877 PMCID: PMC6518051
Portegijs E, Rantakokko M, Viljanen A, Sipilä S, Rantanen T. Is frailty associated with life-space mobility and perceived autonomy in participation outdoors? a longitudinal study. Age Ageing. 2016;45(4):550-3. https://doi.org/10.1093/ageing/afw072
Chitalu P, Tsui A, Searle SD, Davis D. Life-space, frailty, and health-related quality of life. BMC Geriatr. 2022;22(1):646. https://doi.org/10.1186/s12877-022-03355-2
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The Journal of Thailand Nursing and Midwifery Council
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
