Frailty and incidence of activities of daily living disability among older Mexican Americans

Objective: To examine the association between frailty status and incidence of disability among non-disabled older Mexican Americans. Design: A 10-year prospective cohort study. Subjects: A total of 1645 non-institutionalized Mexican Americans aged 67 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE), who reported no limitation in activities of daily living at baseline. Methods: Frailty was defined as meeting 3 or more of the following components: (i) unintentional weight loss of > 2.26 kg; (ii) weakness (lowest 20% in hand grip strength); (iii) self-reported exhaustion; (iv) slow walking speed; and (v) low physical activity level. Socio-demographic factors, Mini Mental State Examination, medical conditions, body mass index, and self-reported activities of daily living were obtained. Results: Of the 1645 non-disabled subjects at baseline, 820 (50%) were not frail, 749 (45.7%) were pre-frail, and 71 (4.3%) were frail. The hazard ratio of activities of daily living disability at 10-year follow-up for pre-frail subjects was 1.32 (95% confidence interval 1.10-1.58) and 2.42 (95% confidence interval 70-3.46) for frail subjects compared with not frail subjects. This association remained statistically significant after controlling for potential confounding factors at baseline. Conclusion: Pre-frail and frail status in older Mexican Americans was associated with an increased risk of activities of daily living disability over a 10-year period among non-disabled subjects.