The association between frailty, emergency admission and mortality in the PRIME-UK cross-sectional study

Introduction

Parkinsonism is more common amongst older people, so many patients are also living with frailty, which has been associated with adverse outcomes. However, there are no Parkinson’s-specific frailty measures. Those based on the frailty phenotype often require in-person assessment including handgrip strength and walking speed. We have previously shown that the Survey of Health, Ageing and Retirement in Europe Frailty Index (SHARE-FI)75+ was feasible for self-completion and predicted functional ability [1]. We aimed to test whether it predicts hospitalisation and mortality.

Methods

In this single-centre study, which particularly sought to reach under-served groups, participants self-reported answers to the five components of SHARE-FI75+ [2]. This generated a score between 0 and 1, where a higher score indicated greater frailty. Mortality and emergency hospitalisation data was obtained. Logistic regression was used to explore the association between frailty score and the composite outcome death or emergency hospitalisation in the 2.5-years after questionnaire completion.

Results

471 out of 475 recruited participants (mean age 76 ±8.5 years, 65% male, 70% frail/pre-frail) had complete data for SHARE-FI75+, of whom 76 died and 139 died or had an emergency admission in the 2.5-year period. For each standard deviation increase in frailty score, odds of death or emergency admission nearly doubled (OR 1.93; 95% CI 1.56, 2.40; p < 0.001). This was partially attenuated after adjustment for age (OR 1.60; 95% CI 1.25, 2.05, p < 0.001).

Key conclusions

Frailty score, calculated using SHARE-FI75+ and without in-person assessment, predicted death or emergency hospitalisation in people with parkinsonism.