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UPJ INSIGHT: Population Trends in Frailty in Older Adults with Benign Urological Conditions in Northern California
By: Farnoosh Nik-Ahd, MD; Chengshi Jin, PhD; W. John Boscardin, PhD; Anne M. Suskind, MD, MS | Posted on: 01 Aug 2022
Nik-Ahd F, Jin C, Boscardin J et al: Population trends in frailty in older adults with benign urological conditions in Northern California. Urol Pract 2022; 9: 314.
Study Need and Importance
Frailty is defined as a state of vulnerability in which individuals have a phenotype of decreased physiological reserve and function, and is known to be associated with increased rates of postoperative complications and mortality. It is known that disparities related to access to care and socioeconomic status often vary geographically. Therefore, we sought to understand regional variation of frailty using the Timed Up and Go Test (TUGT) across health service areas (HSAs) in Northern and Central California among older adults presenting to our academic tertiary care center with benign urological conditions.
What We Found
A total of 2,596 subjects were stratified into 69 HSAs in Northern and Central California. Twenty-one HSAs were categorized as robust (not frail) and 48 HSAs were categorized as prefrail/frail. Prefrail/frail HSAs were significantly associated with subjects that were of older age (adjusted odds ratio [aOR] 4.03, CI 3.29–4.94, p <0.001), female sex (aOR 1.10, CI 1.07–1.11, p <0.001), non-White race (aOR 1.12, CI 1.10–1.14, p <0.001), underweight body mass index (BMI; aOR 1.14, CI 1.07–1.22, p <0.001) and obese BMI (aOR 1.06, CI 1.04–1.08, p <0.001). There was a 1.7-fold difference in mean TUGT values across HSAs (see Figure).
Limitations
This study used a single measure of frailty, the TUGT, which is a validated surrogate marker of frailty with high sensitivity and specificity. Additionally, this study utilized data from a single academic center, potentially limiting the generalizability of our findings.
Interpretation for Patient Care
Among older adults with benign urological disease, frailty varies based on geographic location. Older age, non-White race, and underweight and obese BMIs were found to be associated with geographic areas with increased frailty. Further studies into health disparities as they pertain to geography and frailty are needed to expand upon these findings.