How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden

Archives of Gerontology and Geriatrics

Volumn 53, Issue 1, 2011, Pages 40-45

  Ernsth Bravell, Marie ^a   Westerlind, Björn ^b   Midlöv, Patrik ^c   Östgren, Carl Johan ^d   Borgquist, Lars ^d   Lannering, Christina ^e   Mölstad, Sigvard ^e  

^a JÖNKÖPING UNIVERSITY   (Sweden)

^b RYHOV COUNTY HOSPITAL   (Sweden)

^c LUND UNIVERSITY   (Sweden)

^d LINKÖPING UNIVERSITY   (Sweden)

^e Unit of Research and Development in Primary Care   (Sweden)

Author keywords

Cognitive function; Community dwellings; Frailty; Risk assessments

Indexed keywords

ACETYLSALICYLIC ACID; ANTIDEPRESSANT AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CYANOCOBALAMIN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; FOLIC ACID; HEMOGLOBIN; HYPNOTIC AGENT; LAXATIVE; NEUROLEPTIC AGENT; OPIATE; PARACETAMOL; PROTON PUMP INHIBITOR; SEDATIVE AGENT;

AGE; AGED; ARTICLE; BODY MASS; COGNITIVE DEFECT; COMMUNITY LIVING; COMORBIDITY; DECUBITUS; DEMENTIA; DIASTOLIC BLOOD PRESSURE; DOWNTON FALL RISK INDEX; ELDERLY CARE; FALL RISK ASSESSMENT; FALLING; FEMALE; FRAIL ELDERLY; HEART FAILURE; HEMOGLOBIN BLOOD LEVEL; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; MALNUTRITION; NUTRITIONAL ASSESSMENT; NUTRITIONAL STATUS; PHYSICAL CAPACITY; POLYPHARMACY; PRIORITY JOURNAL; PULSE PRESSURE; RISK ASSESSMENT; STROKE; SWEDEN; SYMPTOM; SYSTOLIC BLOOD PRESSURE;

ACCIDENTAL FALLS; AGED; AGED, 80 AND OVER; COGNITION DISORDERS; COMORBIDITY; FEMALE; FRAIL ELDERLY; GERIATRIC ASSESSMENT; HOMES FOR THE AGED; HUMANS; MALE; MALNUTRITION; NURSING HOMES; POLYPHARMACY; PRESSURE ULCER; SEX FACTORS; SWEDEN;

EID: 79957978726     PISSN: 01674943     EISSN: 18726976     Source Type: Journal    
DOI: 10.1016/j.archger.2010.06.011     Document Type: Article

References (35)

1. Ahmed N., Mandel R., Fain M.J. Frailty: an emerging geriatric syndrome. Am. J. Med. 2007, 120:748-753.
2. Alexopoulos G.S., Abams R.C., Young R.C., Shamolan C.A. Cornell scale for depression in dementia. Biol. Psychiatry 1988, 23:271-294.
3. Andersson, A., 2003. SNAC - The Swedish National Study on Aging and Care. Vårdsystemdelen [care system part]. Available from: [2010-01-17]. http://www.snac.org/.
4. Bååth C., Hall-Lord M.L., Idvall E., Wiberg-Hedman K., Larsson B. Interrater reliability using Modified Norton Scale, Pressure Ulcer Card. Short Form-Mini Nutritional Assessment by registered and enrolled nurses in clinical practice. J. Clin. Nurs. 2008, 17:618-626.
5. Charlson M.E., Pompei P. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic. Dis. 1987, 40:373-383.
6. Chen P.C., Wilmoth J.M. The effects of residential mobility on ADL and IADL limitations among the very old living in the community. J. Gerontol. B: Psychol. Sci. Soc. Sci. 2004, 59:S164-S172.
7. Dahl, A., 2009. Body mass index, cognitive ability, and dementia. Prospective associations and methodological issues in late life. Dissertation No. 7. School of Health Sciences, Jönköping University, Sweden.
8. Dahl A., Hassing L.B., Fransson E., Berg S., Gatz M., Reynolds C.A., Pedersen N.L. Being overweight in midlife is associated with lower cognitive ability and steeper cognitive decline in late life. J. Gerontol. A: Biol. Sci. Med. Sci. 2009, 65:57-62.
9. De Girolamo G., Tempestini A., Cavrini G., Scocco P., Argentino P., Federici S., Putzu P., Zappia M., Morosini P., Cascavilla I., Azzarito C., Brancati G., Spalletta G., Calvaruso A., Lucidi F., Pasini A. Residential facilities for older people in Italy: a five-region survey. Aging Clin. Exp. Res. 2007, 19:132-138. PROGRES-Older People Project.
10. Downton J.H. Falls in the Elderly 1993, Edward Arnold, London.
11. Ek A.C., Unosson M., Bjurulf P. The modified Norton scale and the nutritional intake. Scand. J. Caring Sci. 1989, 3:183-187.
12. Ernsth Bravell, M., 2007. Care trajectories in the oldest old. Dissertation Series No. 3. School of Health Sciences, Jönköping University.
13. Ernsth Bravell M., Berg S., Malmberg B., Sundström G. Sooner or later? A study of institutionalization in late life. Aging Clin. Exp. Res. 2009, 21:329-337.
14. Finlayson M. Changes predicting long-term care use among the oldest-old. Gerontologist 2002, 42:443-453.
15. Folstein M.F., Folstein S.E., McHugh P.R. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J. Psychiatry Res. 1975, 12:189-198.
16. Gallucci M., Ongaro F., Amici G.P., Regini C. Frailty, disability and survival in the elderly over the age of seventy: evidence from " the Treviso Longeva (TRELONG) Study" Arch. Gerontol. Geriatr. 2009, 48:281-283.
17. Gaugler J.E., Kane R.L., Kane R.A., Clay T., Newcomer R.C. The effects of duration of caregiving on institutionalization. Gerontologist 2005, 45:78-89.
18. Gold C.H., Malmberg B., McClearn G.E., Pedersen N.L., Berg S. Gender and health: a study of older unlike-sex twins. J. Gerontol. B: Psychol. Sci. Soc. Sci. 2002, 57:S168-S176.
19. Greene V.L., Ondrich J.I. Risk factors for nursing home admissions and exits: a discrete-time hazard function approach. J. Gerontol. 1990, 45:S250-S258.
20. Hassing L.B., Dahl A.K., Thorvaldsson V., Berg S., Gatz M., Pedersen N.L., Johansson B. Overweight in midlife and risk of dementia: a 40-year follow-up study. Int. J. Obes. (London) 2009, 33:893-898.
21. Hays J.C. Living arrangements and health status in later life: a review of recent literature. Public Health Nurs. 2002, 19:136-151.
22. Hays J.C., Pieper C.F., Purser J.L. Competing risk of household expansion or institutionalization in late life. J. Gerontol. B: Psychol. Sci. Soc. Sci. 2003, 58:S11-S20.
23. Klein B.E., Klein R., Knudtson M.D., Lee K.E. Frailty, morbidity and survival. Arch. Gerontol. Geriatr. 2005, 41:141-149.
24. Molander L., Lövheim H., Norman T., Nordström P., Gustafson Y. Lower systolic blood pressure is associated with greater mortality in people aged 85 and older. J. Am. Geriatr. Soc. 2008, 56:1853-1859.
25. Morley J.E. Caring for the vulnerable elderly: are available quality indicators appropriate?. J. Am. Med. Dir. Assoc. 2008, 9:1-3.
26. National Board of Health and Welfare, 2005. Elderly who move into special types of housing for service and care. Evaluation of the situation in Sundsvall, 2005. National Board of Welfare, Stockholm (in Swedish).
27. National Board of Health and Welfare, 2009. Survey of resources in dementia care. National Board of Welfare, Stockholm (in Swedish).
28. Pickering G. Frail elderly, nutritional status and drugs. Arch. Gerontol. Geriatr. 2004, 38:174-180.
29. Rockwood K., Stadnyk K., MacKnight C., McDowell I., Hébert R., Hogan D.B. A brief clinical instrument to classify frailty in elderly people. Lancet 1999, 353:205-206.
30. Rockwood K., Abeysundera M., Mitnitski A. How should we grade frailty in nursing home patients?. J. Am. Med. Dir. Assoc. 2007, 8:595-603.
31. Rosendahl, E., 2006. Fall prediction and a high-intensity functional exercise programme to improve physical functions and to prevent falls among older people living in residential care facilities. Doctoral Dissertation No. 1024. Department of Community Medicine and Rehabilitation Geriatric Medicine and Physiotherapy, Umeå University, Sweden.
32. Rovine, M.J., Von Eye, A., Wood, P., 1988. The effect of low covariate criterion correlations on the analysis-of-covariance. In: Wegmen, E. (Ed.), Computer Science and Statistics: Proceedings of the 20th Symposium of the Interface. American Statistical Association, Alexander, VA, pp. 355-357.
33. Rubenstein, L.Z., Harker, J., Guigoz, Y., Vellas, B., 1999. Comprehensive geriatric assessment (CGA) and the MNA: an overview of CGA, nutritional assessment, and development of a shortened version of the MNA. In: Vellas, B., Garry, P.J., Guigoz, Y. (Eds.), Mini Nutritional Assessment (MNA): Research and Practice in the Elderly, Nestleó, Basel. Workshop Series Clinical and Performance Programme, vol. 1, pp. 101-116.
34. SNAC, 2010. SNAC - Kungsholmen Vårdsystem. Anvisningar och definition av koder 2006-11-01 [SNAC - Kungsholmen Caresystem. Directions and definitions of codes 2006-11-01] Information in Swedish. Available from: [2010-02-26]. http://www.aldrecentrum.se/snack/images/anvisningar.pdf.
35. Van Houtven C.H., Norton E.C. Informal care and health care use of older adults. J. Health Econ. 2004, 23:1159-1180.