Background: previously, frailty indices were constructed using mostly subjective health measures. The reporting error in this type of measure can have implications on the robustness of frailty findings. Objective: to examine whether frailty assessment differs when we construct frailty indices using solely self-reported or test-based health measures. Design: secondary analysis of data from The Irish LongituDinal study on Ageing (TILDA). Subjects and methods: 4,961 Irish residents (mean age: 61.9 ± 8.4; 54.2% women) over the age of 50 years who underwent a health assessment were included in this analysis. We constructed three frailty indices using 33 self-reported health measures (SRFI), 33 test-based health measures (TBFI) and all 66 measures combined (CFI). The 2-year follow-up outcomes examined were all-cause mortality, disability, hospitalisation and falls. Results: all three indices had a right-skewed distribution, an upper limit to frailty, a non-linear increase with age, and had a dose–response relationship with adverse outcomes. Levels of frailty were lower when self-reported items were used (SRFI: 0.12 ± 0.09; TBFI: 0.17 ± 0.15; CFI: 0.14 ± 0.13). Men had slightly higher frailty index scores than women when test-based measures were used (men: 0.17 ± 0.09; women: 0.16 ± 0.10). CFI had the strongest prediction for risk of adverse outcomes (ROC: 0.64–0.81), and age was not a significant predictor when it was included in the regression model. Conclusions: except for sex differences, characteristics of frailty are similar regardless of whether self-reported or test-based measures are used exclusively to construct a frailty index. Where available, self-reported and test-based measures should be combined when trying to identify levels of frailty.

To examine the impact of frailty on medical and social care utilisation among the Irish community-dwelling older population to inform strategies of integrated care for older people with complex needs. Participants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) representative of the Irish community-dwelling older population were analysed (n = 3507). The frailty index was used to examine patterns of utilisation across medical and social care services. Multivariate logistic and negative binomial regression models were employed to examine the impact of frailty on service utilisation outcomes after controlling for other factors. The prevalence of frailty and pre-frailty was 24% (95% CI: 23, 26%) and 45% (95% CI: 43, 47%) respectively. Frailty was a significant predictor of utilisation of most social care and medical care services after controlling for the main correlates of frailty and observed individual effects. Frailty predicts utilisation of many different types of healthcare services rendering it a useful risk stratification tool for targeting strategies of integrated care. The pattern of care is predominantly medical as few of the frail older population use social care prompting questions about sub-groups of the frail older population with unmet care needs.

Few data are available examining the determinants of vitamin D status exclusively in older adults. We aimed to investigate the prevalence and determinants of vitamin D deficiency in a representative sample of the older Irish population (aged 50–98 years). The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 5,356 community-dwelling older Irish adults from The Irish Longitudinal Study on Ageing (TILDA). Detailed demographic, geographic, lifestyle, and socioeconomic factors were assessed by questionnaire. Proportions of deficiency prevalence were generated by season sampled. Linear regression was used to investigate the association between 25(OH)D concentration and reported risk factors. The prevalence of deficiency (25(OH)D < 30 nmol/L) was 13.1% (95% CI: 12.1–14.2). Deficiency status was more prevalent in nonsupplement users, in winter, in smokers, in obese adults, the physically inactive, those living alone, and in the oldest old (>80 years). The main predictors (p < .05) of 25(OH)D concentration were supplement use (coefficient nmol/L: 27.2 [95% CI: 15.3–39.2]), smoking (−8.9 [−12.6–−5.2]), summer season (5.9 [2.7–9.1]), and obesity (−4.0 [−6.3–−1.7]). Vitamin D deficiency is common among older Irish adults. These data indicate the need for targeted strategies within sections of the older population to improve vitamin D status.

Background: frailty is an important geriatric syndrome linked to increased mortality, morbidity and falls risk. Methods: a total of 399 community-dwelling older adults were assessed using Fried's frailty phenotype and the timed up and go (TUG) test. Tests were quantified using shank-mounted inertial sensors. We report a regression-based method for assessment of frailty using inertial sensor data obtained during TUG. For comparison, frailty was also assessed using the same method based on grip strength and manual TUG time. Results: using inertial sensor data, participants were classified as frail or non-frail with mean accuracy of 75.20% (stratified by gender). Using TUG time alone, frailty status was classified correctly with mean classification accuracy of 71.82%. Similarly, using grip strength alone, the frailty status was classified correctly with mean classification accuracy of 77.65%. Stratifying sensor data by gender yielded significantly (p<0.05) increased accuracy in classifying frailty when compared with equivalent manual TUG time-based models. Conclusion: results suggest that a simple protocol involving assessment using a well-known mobility test (Timed Up and Go (TUG)) and inertial sensors can be a fast and effective means of automatic, non-expert assessment of frailty.

We investigated whether sustained attention performance and variability were associated with prefrailty and frailty in the older adult population. A total of 4,317 participants aged 50 years and over from the Irish Longitudinal Study on Ageing (TILDA) completed a comprehensive health assessment. Frailty was defined by low gait speed, low grip strength, unintentional weight loss, self-reported exhaustion, and low physical activity. Scores of greater than or equal to 3, 1–2, and 0 indicated that participants were frail, prefrail, and nonfrail, respectively. Multinomial logistic regression computed associations between frailty state and measures of performance and variability on the Sustained Attention to Response Task (SART). Cognitive processing speed and executive function were also measured. Mean reaction time (RT; odds ratio [OR] = 1.13, p < .05) and RT variability reflective of the top-down aspect of sustained attention (OR = 1.11, p < .05) were associated with prefrailty in the 50–64 age group. Mean RT (OR = 1.72, p < .05) was associated with frailty and RT variability (OR = 1.22, p < .01) with prefrailty in the 65+ age group. Results remained significant following adjustments for cognitive processing speed, executive function, chronic conditions, medications, age, and gender. Sustained attention performance and variability were associated with prefrailty and frailty in the older adult population and may represent a novel, objective, and modifiable cognitive marker of frailty progression.