Comparative frequency of frailty syndrome in the elderly, taking into account updated clinical guidelines

BACKGROUND: Frailty syndrome is associated with impaired physical, psychological and social functioning of organs and systems. Its frequency during screening in among community-dwelling patients is very high according to Russian literature. However, during the revision of the clinical guidelines "Frailty" in 2024, the diagnostic algorithm became simpler and does not require the identification of pre-frailty syndrome and people with impaired functional and psychological status before performing a comprehensive geriatric assessment. There is a question whether the incidence of frailty syndrome and associated geriatric syndromes has changed when using the updated diagnostic algorithm.

AIM: To assess the frequency of frailty syndrome in people aged 60 years and older in accordance with the 2020 and 2024 clinical guidelines and to establish a link with geriatric syndromes.

MATERIALS AND METHODS: A cross-sectional, single-center study with a random sample of individuals aged 60 years and older included 462 among community-dwelling people (77 men and 385 women) after signing informed consent, attached to a primary health care institution in St. Petersburg. The median age of patients was 76 (62-83) years. Frailty syndrome was diagnosed according to clinical guidelines for 2020 and 2024, followed by a comprehensive geriatric assessment using questionnaires and scales. Muscle strength was assessed using a MEGEON-34090 digital hand dynamometer (Russia).

RESULTS: No significant differences were found in the frequency of frailty syndrome in the overall sample of elderly people using the 2020 and 2024 diagnostic criteria (25.7 and 29.9%, respectively, p = 0.164), as well as in different age groups, in men and women (p> 0.05). Рre-frailty syndrome was detected in 60.4%, which was not diagnosed according to the 2024 criteria. Of these, 36.9% of patients had decreased mobility according to the SPPB and 10.7% were suspected of having cognitive impairment according to the Mini-Cog test. In patients with frailty syndrome, muscle strength was 3.9  times weaker (р < 0,0027), and physical performance was almost 9 times lower (р < 0,0015) when the 2020 clinical guidelines were applied, and skeletal muscle function was reduced by less than 2 times when using the diagnostic algorithm according to the 2024 criteria.

CONCLUSIONS: The frequency of frailty syndrome assessed according to the 2020 and 2024 clinical guidelines had no gender or age differences. When screening for frailty using the 2024 clinical guidelines, 36.9% of patients with previously diagnosed pre-frailty syndrome may not be examined for functional status disorders. Reduced mobility increases the risk of developing frailty syndrome.