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Prevalence of Frailty in Older Community-Dwelling Tanzanians According to Comprehensive Geriatric Assessment.
Journal of the American Geriatrics Society 2018 August
OBJECTIVES: To investigate the prevalence of frailty using a Comprehensive Geriatric Assessment (CGA) in older community-dwelling adults living in rural northern Tanzania.
DESIGN: Cross-sectional survey.
SETTING: Five randomly selected villages in Hai District, Kilimanjaro region, Tanzania.
PARTICIPANTS: All adults aged 60 and older living in the selected villages were eligible to participate, including older adults with cognitive impairment provided a close relative was able to assent on their behalf. All participants were community dwelling because institutionalization is very rare.
MEASUREMENTS: Participants were screened using a short frailty screening tool, the Brief Frailty Instrument for Tanzania (B-FIT), comprising an abbreviated test of cognitive function and the Barthel Index, which assesses functional independence. Based on B-FIT score, a frailty-weighted, stratified sample was selected for in-depth assessment using CGA and characterized as frail or not frail.
RESULTS: Two hundred thirty-six CGAs were performed in 1,207 people screened, 91 of whom were deemed frail. After adjusting for stratification, the prevalence of frailty was 19.1% (95% confidence interval=15.2-23.1).
CONCLUSION: This is the first study in sub-Saharan Africa to report the prevalence of frailty in community-dwelling older adults according to a CGA. The strengths of reporting frailty according to a CGA include the ability to consider likely medical diagnoses based on clinical assessment and to assess individuals' social circumstances and environment.
DESIGN: Cross-sectional survey.
SETTING: Five randomly selected villages in Hai District, Kilimanjaro region, Tanzania.
PARTICIPANTS: All adults aged 60 and older living in the selected villages were eligible to participate, including older adults with cognitive impairment provided a close relative was able to assent on their behalf. All participants were community dwelling because institutionalization is very rare.
MEASUREMENTS: Participants were screened using a short frailty screening tool, the Brief Frailty Instrument for Tanzania (B-FIT), comprising an abbreviated test of cognitive function and the Barthel Index, which assesses functional independence. Based on B-FIT score, a frailty-weighted, stratified sample was selected for in-depth assessment using CGA and characterized as frail or not frail.
RESULTS: Two hundred thirty-six CGAs were performed in 1,207 people screened, 91 of whom were deemed frail. After adjusting for stratification, the prevalence of frailty was 19.1% (95% confidence interval=15.2-23.1).
CONCLUSION: This is the first study in sub-Saharan Africa to report the prevalence of frailty in community-dwelling older adults according to a CGA. The strengths of reporting frailty according to a CGA include the ability to consider likely medical diagnoses based on clinical assessment and to assess individuals' social circumstances and environment.
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