Revista INFAD de Psicología:  ISSN: 0214-987
2014 (IJODAEP) Nº2, Vol. 1, pp. 193 doi:


Revista INFAD 2014


Mafalda Gomes Duarte 1,2

Inácio Guinaldo Martín 1,3

Constança Paúl 1

1 Research and Education Unit on Aging – UNIFAI ICBAS
University of Porto Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto (Portugal)
Phone. +351 220 428 161 | URL:

2 Superior School of Health of Alto Ave (ISAVE), Portugal
Campus Académico do ISAVE, Quinta de Matos – Geraz do Minho 4830-316
P. de Lanhoso (Portugal)
Phone. +351 253 639 800 | Fax – +351 253 639 801 | URL:

3 Health department of the University of Aveiro
Campus Universitário de Santiago 3810-193
Aveiro (Portugal)
Phone. +351 234 401 558 | Fax: +351 234 401 597 | URL:

* Corresponding Author Mafalda Duarte
UnIFai, Institute of Biomedical Sciences Abel Salazar,
Dpt. Behavioural Sciences,
University of Porto,
Lg. Rua Jorge Viterbo Ferreira, 228, 4050-313
Porto, Portugal. Phone: + 351 220 480 161

Fecha de recepción: 15/10/2014
Fecha de aceptación: 18/10/2014
Fecha de publicación: 05/11/2014

ABSTRACT Background: The Phenotype of Frailty is a syndrome composed of five criteria: weight loss, endurance, physical activity, slowness and weakness. The elder is considered frail if he/she has an impairment in three of these domains. It is known that this condition enhances the risk of disability and death. The objective of this study is to identify predictive and protective factors of frailty.

Methods: This study includes a representative sample, stratified by age group, of elders living in the community (n=339). We developed a frailty protocol, which integrated the criteria of frailty and bio behavioural, geriatric, functionality, health and mental health self-perception indicators.

Results: From the analysis of logistic regression models the demographic predictor are: gender (being a woman) (OR 1.7, 95% CI 1,0 – 2,8), age (more advanced) (OR 2.8, 95% CI 1.6 – 4.9) and educational level (no schooling) (OR 2.6, 95% CI 1.1 – 6.0). The bio behavioural variables and the low respiratory flow predict the condition of frailty (OR 3.3, 95% CI 1.9 – 6.0). Geriatric indicators as falls (OR 3.3, 95% CI 1.5 – 5.6), changes in sensory processes, vision and hearing (OR 2.1, 95% CI 1.2 -3. 8; OR 2.1, 95% CI 1.1 – 4.0 respectively) and the presence of at least one comorbidity (OR 1.8, 95% CI 1.0 – 3.2) are predictors of frailty. Impairment in ADL increases the risk of frailty (OR 2,1, 95% IC 1.2 -3.5). The presence of depressive symptomatology (OR 4.2, 95% IC 1.9-9.2) and cognitive deterioration (OR 2.9, 95% IC 1.6 -5.3) are equally predictive of this condition. On the other hand, maintaining social relations (OR 0.3, 95% IC 0.1-0.5) and a good self-perception health are protective of the condition of frailty (OR 0.4, 95% IC 0.1-0.9).

Conclusions: Frailty can be predicted through a set psychosocial and geriatric factors. Protective indicators such as social relations and subjective health act as protective factor of frailty. Keywords: Aging, Phenotypic frailty, Predictor factors , Protector indicators.


Gomes-Duarte, Mafalda; Guinaldo-Matin, Inácio y Paúl, Constança. «Predictor model of frailty in old age». International Journal of Developmental and Educational Psychology. N.o2, Volumen 1,(5 de noviembre de 2014): 8.

  • Abate, M., Di Iorre, A., Di Renzo, D., Paganalli, R. Saggini, R., & Abate, G. (2007). Frailty in the elderly: physical dimensions. Eura Medicophys Journal, 43(3), 407- 4115.
  • Abellan Van Kan, G., Rolland, Y., Bergman, H., Morley, J.E., Kritchevsky, S.B.& Vellas, B. (2008). The I.A.N.A Task Force on frailty assessment of older people in clinical practice. Journal of Nutrition Health and Aging, 12(1), 29-37. PMid:18165842
  • Andersen, K., Lolk, A. Kraugh-Sorensen, P., Petersen, N.E. & Green, A. (2005). Depression and risk of Alzheimer disease. Epidemiology, 16, 233-238. PMid:15703539
  • Ávila- Funes, J.A., Helmer, C., Amieva, H., Barberger-Gateau, P., Le Goff, M., Ritchie, et al. (2008). Frailty among community – dwelling elderly people in France: The Three- City Study. Journal of Gerontology, 63A(10), 1089-1096.
  • Ávila-Funes, J. A., Amieva, H., Barberger-Gateau, P., Le Goff, M., Raoux, N., Ritchie, K., et al. (2009). Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the Three-City Study. Journal of American Geriatrics Society, 57, 453-461. PMid:19245415
  • Bandeen – Roche, K., Xue, Q. L., Ferrucci, L., Walston, J., Guralnik, J.M., Chaves, P., et al. (2006). Phenotype of frailty: characterization in the Women´s Health and Aging Studies. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61A, 262-266.
  • Bergman, H., Ferrucci, L., Guralnik, J., Hogan, D. B., Hummel, S., Karunananthan et al. (2007). Frailty: an emerging research and clinical paradigm – issues and controversies. Journal of Gerontology: Medical Sciences, 62A(7), 731- 737.
  • Bruce, M. L. (2001). Depression and disability in later life. American Journal Geriatric Psychiatry, 9, 102-112.
  • Buchner, D. M., & Wagner, E. H. (1992). Preventing frail health. Clinics in Geriatric Medicine, 8, 1-17. PMid:1576567
  • Campbell, A. J., & Buchner, D. M. (1997). Unstable disability and the fluctuations of frailty. Age and Ageing, 26, 315-318. PMid:9271296
  • Cawthon, P. M., Marshall, L. M., Michael, Y., Dam, T.T., Ensrud, K.E. & Barrett- Conner, E. (2007). Frailty in older men: prevalence, progression and relationship with mortality. Journal of American Geriatrics Society, 55, 1216- 1223. PMid:17661960
  • Chang, S. S., Weiss, C. O., Xue, Q. L., & Fried, L. P. (2010). Patterns of comorbid inflammatory diseases in frail older women: The Women´s Health and Aging Studies I and II. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 65(4), 407- 413. PMid:19933749 PMCid:PMC3004772
  • Collard, R. M., Boter, H., & Schoevers, R. A. (2012). Prevalence of frailty in community- dwelling older persons: a systematic review. Journal American Geriatric Society, 60, 1487-1492. PMid:22881367
  • Corapi, K. M., Mcgee, H. M., & Barker, M. (2006). Screening for frailty among seniors in clinical practice. Nature Clinical Practice Rheumatology, 2(9), 476-480. PMid:16951702
  • Duarte, M., & Martín, I. (2008). Scale of Occupation time. Research and Education Unit on Aging – UNIFAI ICBAS-University of Porto.
  • Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., Anderson, G. (2004). Untangling the concepts of disability, frailty and comorbidity: implications for improved targeting and care. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 59(3), 255 – 63.
  • Fried, L., Tangen, C., Walston, J., Newman, A., Hirsch, C., Gottdiener, J., Seeman, T., Tracy, R., Kop, W., & Burke, G. (2001). Frailty in Older Adults: Evidence for Phenotype. Journal of Gerontology: Medical Sciences, 56 A(3), 146-156.
  • Gill, T. M., Williams, C. S., Richardson, E. D., & Tinetti, M. E. (1999). Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. Journals of Gerontology: A Biological Sciences and Medical Sciences, 51A, 283-288.
  • Gill T.M, Evelyne A., Gahbauer,A., Heather, G. & Ling Han (2006)Transitions Between Frailty States Among Community-Living Older PersonsArchives of International Medicine, 166, 418-23.
  • Graham, J. E., Snih, S. A., Berges, I. M., Ray, L. A. Markides, K. S., & Ottenbacher, K.
  • J. (2009). Frailty and 10-year mortality in community – living Mexican American older adults. Gerontology, 55, 644-651.
  • Hamerman, D. (1999). Towards an understanding and criteria of frailty. Annals of Internal Medicine, 130, 945-950. PMid:10375351
  • INE (2011). Aging in Portugal, Lisbon: DECP/Services Studies.
  • Kerr, A., Syddall, H. E., Cooper, C., Turner, G., Briggs, R., & Sayer, A. (2006). Does admission grip strength predict length of stay in hospitalized older patients. Age Ageing, 35, 82-84. PMid:16364940
  • Laursen, T. M., Munk-Olsen, T., Nordentoft, M., & Mortensen, P. B. (2007). Increased mortality among patients admitted with major psychiatric disorders: a register based study comparing mortality in unipolar depressive disorder, bipolar affective disorder, schizoaffective disorder and schizophrenia. Journal Clinical Psychiatry, 68, 899-907.
  • Levers, M. J., Estabrooks, C. A., & Ross Kerr, J. C. (2006). Factores contributing to frailty: literature review. Journal of Advanced Nursing, 56(3), 282-291. PMid:17042807
  • Markle – Reid, M., & Browne, G. (2003). Conceptualization of frailty in relation to older adults. Journal of Advanced Nursing, 44(1), 58-68.
  • Metzelthin, S. F., Daniels, R., Van Rossum, E., Witte, L., Van den Heuvel, W. J., & Kempen, G. I. (2010). The psychometric properties of three self-report screening instruments of identifying frail older people in the community. BMC Public Health, 10, 176. PMid:20353611 PMCid:PMC2868816
  • Mezuk, B., Edwards, L., Lohman, M., Choi, M., & Lapane, K. (2011). Depression and frailty in later life: a synthetic review. International Journal Geriatric Psychiatry, 27(9), 879-892. PMid:21984056 PMCid:PMC3276735
  • Ostir, G. V., Ottenbacher, K. J., & Markides, K. S. (2004). Onset of frailty in older adults and proactive role of positive affect. Psychology and Aging, 19, 402-408. PMid:15382991
  • Pel-Little, R. E., Schuurmans, M. J., Emmelot-Vonk, M. H., & Verhaar, H. J. J. (2009). Frailty: Defining and measuring of a concept. The Journal of Nutrition Health & Aging, 13(4), 390-394.
  • Podsiadlo, D., & Richardson, S. (1991). The timed “Up and Go” test of basic functional mobility for frail elderly persons. Journal American Geriatric Society, 39, 142-148. PMid:1991946
  • Puts, M. T., Shekary, N., Widdershoven, G., Heldens, J., Lips, P., & Deeg, D. J. (2007). What does quality of life mean to older frail and non-frail community-dwelling adults Netherlands? Quality of Life Research, 16, 263-277. PMid:17033894
  • Rochat, S., Cumming, R. G., Blyth, F., Creasey, H. & Handelsman, D. (2010). Frailty and use health community services by community-dwelling older men: the Concord Health and Ageing in men project. Age and Ageing, 39, 228-233. PMid:20075036
  • Rockwood, K., Fox, R. A., Stolee, P., Robertson, D., & Beattie, L. (1994). Frailty in elderly people: an evolving concept. Canadian Medical Association Journal, 150, 489- 495. PMid:8313261 PMCid:PMC1486322
  • Rockwood, K., Standnyk, K., Macknight, C., McDoweel, I., Hebert, R., & Hoogan, D.
  • B. (1999). A brief clinical instrument to classify in elderly people. Lancet, 353, 205- 206.
  • Rockwood, K., Howlett, S.E., Macknight, C., et al. (2004). Prevalence, attributes, and outcomes of fitness and frailty in community- dwelling older adults report from Canadian study of health and aging. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 59, 1310-1317.
  • Rovner, B. W., German, B.S., Brant, L.J., Clark, R., Burton, L., & Folstein, M.F. (1991). Depression and mortality in nursing homes. Journal American Medical Association, 265, 993- 996.
  • Santos -Eggimann, B., Cuénoud, P., Spagnoli, J., & Julien, J. (2009). Prevalence of Frailty in middle – aged and older community- dwelling living in 10 countries. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64A(6), 675–681. PMid:19276189 PMCid:PMC2800805
  • Strandberg, T. E., Pitkãlã, K. H., & Tilvis, R. S. (2011). Frailty in older people. European Geriatric Medicine, 2, 344-355.
  • Strawbridge, W. J., Shema, S. J., Balfour, J. L., Higby, H. R., & Kaplan, G. A. (1998). Antecendents of frailty over three decades in an older cohort. Journal of Gerontology: Social Sciences, 53 (1), S9- 16.
  • Syddall, H., Roberts, H., Evandrou, M., Cooper, C., Bergman, H., & Sayer, A. A. (2009). Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study. Age and Ageing, 39,197-203. PMid:20007127 PMCid:PMC3546311
  • Whooly, M. A., Kip, K. E. & Cauley, J. A. (1999). Depression, falls and risk of fracture in older women. International Archives of Medicine, 159, 484-490.
  • Woods, F. N., La Croix, A. Z. & Gray S. L. (2005). Frailty: Emergence and consequences in women aged 65 and older in the Women´s Health Initiative Observational Study. Journal American Geriatric Society, 53, 1321-30. PMid:16078957
  • Xue, Q. L., Fried, L. P.& Glass, T. A. (2007). Life- space constriction, development of frailty, and the competing risk of mortality. American Journal Epidemiology, 167, 240. PMid:17906296
  • Yesavage, J. A., Brink, T. L. & Rose, T. L., (1983). Development and validation of geriatric depression screening scale: a preliminary report. Journal Psychiatric Research, 17, 37- 49.


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