Conceptualizing frailty as a multidimensional construct: Findings from the Hong Kong centenarian study

Abstract

Frailty is a global epidemiological and clinical phenomenon that can lead to poor long-term outcome. Greater understanding of the components of frailty is important for developing better management strategies. We developed a multidimensional Comprehensive Model of Frailty (CMF) and assessed its incremental predictive power over a biologically-based frailty index (FI) on self-rated health and functional dependency. CMF contains indicators in psychological, social/familial, environmental, and economic domains in addition to physical functions and disease. Hierarchical multiple regressions were conducted on the cross-sectional data of Hong Kong Centenarian Study with 124 community-dwelling Chinese near- and centenarians. Results demonstrate that although both CMF and FI were significantly related to poorer self-rated health and greater IADL dependency, CMF provided significant additional predictive power to self-rated health but not to IADL dependency after controlling for age, gender. Expanding the conceptualization of frailty to psychosocial, environmental and economic domains shall facilitate management of this systemic vulnerability.