Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty?

Frailty is considered a predictor for negative outcomes such as disability, decreased quality of life, and hospital admission. Frailty measures have been developed that include different dimensions. We examined whether people who are physically frail are more at risk for negative outcomes of frailty if they also suffer from psychological, cognitive, or social frailty. Frailty was measured at baseline by means of the Groningen Frailty Indicator (GFI), which comprises a physical, cognitive, social, and psychological dimension. Only frail persons were included in the study (GFI a parts per thousand yen 5) that, in addition, had to be frail in the physical dimension (i.e., a parts per thousand yen1 on this dimension). IADL disability and quality of life were measured at baseline and at 12 months. Hospital admission was assessed during this period. In this, physically frail sample effects of the other three frailty dimensions were studied in regression models. The sample (n = 334, mean age 78.1, and range 70-92) included 40.1 % frail men and 59.9 % frail women. Overall, no additional effects for the cognitive, social, or psychosocial dimensions were found: other frailty dimensions did not have an additional impact on disability, quality of life, or hospital admission in people who already suffered from physical frailty. Higher scores of physical frailty were significantly related to IADL disability (p <0.05) and hospital admission (p <0.05). Additional analysis showed that the physical frailty score predicted IADL disability and hospital admission better than the GFI overall score. Results of this study suggest that persons, who are physically frail, according to the GFI, are not more at risk for negative outcomes of frailty (i.e., IADL disability, decreased quality of life, and hospital admission) if they in addition suffer from cognitive, social, or psychological frailty. In addition, for the prediction of IADL disability or hospital admission, the focus for screening should be on the physical frailty score instead of the GFI overall score including different dimensions

FAMILY NEED FOR COMPREHENSIVE POSITIVE BEHAVIORAL SUPPORT

As parents of a 26-year-old man, JT, who has encountered behavioral challenges, the authors are painfully aware of the need for relevant information and especially for a comprehensive network of formal and informal supports to create inclusive, state-of-the-art lifestyle options. This chapter blends both our personal and our professional research perspectives in addressing the following high priority topics for the field of positive behavioral support: 1. The family&apos;s extensive need for comprehensive positive behavioral support 2. Criteria for measuring lifestyle change as contrasted to behavioral change 3. Group Action Planning as a strategy for providing comprehensive family suppor