Frailty trajectories in community‐dwelling older adults during COVID‐19 pandemic: The PRESTIGE study

BACKGROUND: Frailty has been recognized as potential surrogate of biological age and relevant risk factor for COVID‐19 severity. Thus, it is important to explore the frailty trajectories during COVID‐19 pandemic and understand how COVID‐19 directly and indirectly impacts on frailty condition. METHODS: We enrolled 217 community‐dwelling older adults with available information on frailty condition as assessed by multidimensional frailty model both at baseline and at one‐year follow‐up using Multidimensional Prognostic Index (MPI) tools. Pre‐frail/frail subjects were identified at baseline as those with MPI score >0.33 (MPI grades 2–3). Frailty worsening was defined by MPI difference between 12 months follow‐up and baseline ≥0.1. Multivariable logistic regression was modelled to identify predictors of worsening of frailty condition. RESULTS: Frailer subjects at baseline (MPI grades 2–3 = 48.4%) were older, more frequently female and had higher rates of hospitalization and Sars‐CoV‐2 infection compared to robust ones (MPI grade 1). Having MPI grades 2–3 at baseline was associated with higher risk of further worsening of frailty condition (adjusted odd ratio (aOR): 13.60, 95% confidence interval (CI): 4.01–46.09), independently by age, gender and Sars‐CoV‐2 infection. Specifically, frail subjects without COVID‐19 (aOR: 14.84, 95% CI: 4.26–51.74) as well as those with COVID‐19 (aOR: 12.77, 95% CI: 2.66–61.40, p = 0.001) had significantly higher risk of worsening of frailty condition. CONCLUSIONS: Effects of COVID‐19 pandemic among community‐dwelling frailer individuals are far beyond the mere infection and disease, determining a significant deterioration of frailty status both in infected and non‐infected subjects.