Impact of Frailty on Geriatric Patients with Fractures and its Association with Functional Activities

Impact of Frailty on Geriatric Patients

Abstract

Background: Fragility fractures are breaks in the continuity of bones that result from minor traumas caused by mechanical forces that would not usually result in fractures. Geriatric fractures represent a major source of dysfunction and declining health-related quality of life in the elderly following a limb fracture, most of the interventions are centered on restricting mobility dysfunction and improving independence with activities of daily living. Objective: To find the impact of frailty on the geriatric population presenting in the hospital with fractures and how this frailty is associated with their functional status. Methods: An observational cross-sectional study was performed on a sample of 97 geriatric population using non-probability convenient sampling in six months. Permission from the ethics committee of Rashid Latif College of Physical Therapy was obtained to carry out the study. The data was collected from Jinnah Hospital, Arif Memorial Teaching Hospital and National Hospital, Lahore. The inclusion criteria were participants with age 65 years or older, admitted to the hospital and presented with fragility fracture. Participants with a history of high-velocity crush injury, complicated surgical conditions and any malignancy were excluded from the study. Participants were assessed based on the frail questionnaire for frailty and the Groningen frailty index for their functional activities status. The quantitative variables were presented as mean and standard deviation while qualitative variables were evaluated as proportions, frequencies, cross-tabulations, pie charts, etc. The test results for multiple choice questions were compared using a chi-square test. Results: The mean age of the participants was 73.63±6.91, among which 53(54.6%) were males and 44(45.4%) were females. The prevalence of fragility fractures in frail participants was 79.4% and pre-frail participants were 20.6%. About 64.9% of frail participants and 2.1% pre-frail were having impaired functional activities while 56.7% of participants were having fitness between 0-6 out of 10 and 22.7% were having fitness from 7-10 (p=0.047). Conclusion: Frailty index has a significant impact on fractures and is associated with the functional status of participants. Most patients were not able to perform their activities of daily living and those who can perform were having limited functional activities.