Consistent with a frail phenotype, functional scores (ADL, Karnofsky) were lower in the frail subgroup.
In the frail subgroup, the physical performance score was lower after the intervention, whereas there was a positive effect of the intervention on the physical performance score in the pre-frail subgroup.
Nichol et al. discussed that influenza vaccination is common in patients with functional impairments and frailty, [ 6] speaking against the assumption that a terminally ill and frail subgroup of patients is responsible for the observation of off-season estimates.
In two of them [ 13, 32], falls were significantly reduced after exercise training, at least in the pre-frail elderly sample [ 32], but not in the frail subgroup, in which the risk of becoming a faller increased with the intervention [ 32].
The odds ratio with a one-year increment in age was 1.26 (95% CI, 1.22-1.31) for being frail and 1.09 (95% CI, 1.07-1.11) for being pre-frail, compared with the non-frail subgroups, meaning 26% higher odds of frailty and 9% higher odds of pre-frailty per unit increase of age (Table 4: Model 1).
Use of low amounts of alcoholic beverages was reported in two patients in the non-frail subgroup.
Another limitation of our study was the limited size of the subgroups of "frail" and "robust" subjects on which the secondary statistical analyses were performed.
Second, the sample size was not very large, with some subgroups (eg, frail subjects) composed of a very limited number of participants.
The main limitations to their general use are the lack of data for some subgroups of frail patients and the lack of availability of specific antidotes and especially their high cost.
Meta-analyses in the review by Elkan et al. [ 2], including 8/15 studies from van Haastregt et al., also focused on subgroups of frail older persons: no effects were shown on functional status, but positive effects were shown on mortality and nursing home admissions.
The aims of this study were i) to find out which dimensions of QOL are associated with frailty status among community-dwelling older outpatients referred to a geriatric medicine clinic in Italy, and ii) to investigate independent correlates of QOL both in the overall sample and in two specific subgroups, the frail and robust older adults.
