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Title: The epidemiology of frailty and its association with disability and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka
Author: Siriwardhana, Dhammika Deepani
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Abstract:
Background and aim: Frailty is an important age related medical condition that predicts numerous adverse health outcomes. Many low-and middle-income countries (LMICs) are ageing rapidly but we know little about the epidemiology of frailty in these countries. This thesis describes the epidemiology of frailty and its association with disability and quality of life among rural community-dwelling older adults in Kegalle district of Sri Lanka. Methods: Part A) A systematic review and meta-analysis on prevalence of frailty and pre-frailty among community-dwelling older adults in LMICs. Part B) A population-based cross-sectional study conducted in 2016 to i) estimate the prevalence of frailty, ii) describe factors associated with frailty, and iii) evaluate the association of frailty with disability and quality of life among rural community-dwelling older adults in Kegalle district. A three stage probability sampling was used to recruit 746 older adults aged ≥60 years. Frailty was assessed using the Fried phenotype. Results: Part A) Limited evidence was found on the prevalence of frailty in low-income and lower middle-income countries. The random-effects pooled prevalence of frailty and pre-frailty in community-dwelling older adults in LMICs was 17.4% (95% CI: 14.4%, 20.7%) and 49.3% (95% CI: 46.4%, 52.2%) respectively. Part B) The prevalence of frailty and pre-frailty among rural community-dwelling older adults aged ≥60 years in Kegalle district of Sri Lanka was estimated as 15.2% (95% CI: 12.3%, 18.6%) and 48.5% (95% CI: 43.8%, 53.2%) respectively. The prevalence of limitations in instrumental activities of daily living (≥1 IADL) assessed with Lawton IADL scale was high (84.4%) in frail older adults. The prevalence of basic activities of daily living (≥1 BADL) assessed with Barthel index was 38.7% in frail older adults. Being frail lowered the odds of having no IADL limitations and was associated with a four times higher count of IADL limitations compared with non-frail counterparts. Frailty was associated with a small but significant lower quality of life in this rural Sri Lankan population. Conclusions: The prevalence of frailty appears higher in rural community-dwelling older adults in Sri Lanka compared with upper middle-income and high-income countries with a significant impact on IADL limitations but with lower than anticipated impact on BADL limitations and quality of life.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.798486  DOI: Not available
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