[Differences in the expression of the frailty syndrome in institutionalized elderly men and women with no severe cognitive decline].

AIM: To analyse the differences between men and women as regards the prevalence of the frailty syndrome, its association with different sociodemographic and bio-psychosocial health factors, and its impact on the level of dependence of institutionalised elderly men and women with no severe cognitive decline.

METHODS: A cross-sectional, descriptive and multicenter study was conducted in 16 nursing homes in Cuenca (Spain). A representative sample of 281 elderly who fulfilled the inclusion criteria was randomly selected.

MEASURES: frailty following Fried's criteria, age, gender, morbidity, geriatric syndromes, level of dependence, cognitive status, mood and quality of life.

RESULTS: The overall prevalence of frailty was 53.7% (60% among women). The following criteria were associated with frailty: age, respiratory diseases, arthritis, diabetes, sensory deficits, urinary and faecal incontinences, polypharmacy, hospitalization in the past year, functional impairment, cognitive decline and depressive symptoms. The states of frailty were independently associated with dependence (OR=5.1), more strongly in men (OR=7.3) than in women (OR=3.6). Clinical criteria of frailty that best predicted dependence were: exhaustion in women (OR=4.7) and low physical activity in men (OR=12.3).

CONCLUSIONS: The prevalence of frailty found among the institutionalised elderly population was greater than that expected for a general population. Older frail adults had poorer biological and psychosocial health results, suggesting that the physical decline is accompanied by an identity crisis. Frailty expresses differently in men and women. Women have a higher prevalence, but its impact on their dependence is less than men.