Frailty in Hospitalised Older Adults and their Spouses: A Cross-Sectional Study

Introduction: Hospital admissions are a critical time-point for assessing frailty. Frail older adults have high utilisation of healthcare resources and many require on-going care. Often spouses provide this care, however caregiving can lead to increased frailty in the caregiver. A description of frailty and caregiving within marital dyads has not been explored previously, in relation to hospital admissions.

Aim: To measure the frequency and describe the characteristics of frailty in hospitalised older adults and their spouse (dyads).

Objectives were to:

• Describe frailty, physical and cognitive performance in patients and spouses

• Determine frailty correlations between dyads.

• Establish if patients are more likely to have spouses of the same frailty

classification.

• Describe caregiving between patients and spouses within the context of frailty.

Methods: This was a cross-sectional study. Participants were recruited from geriatric and stroke services in an acute hospital from October 2019-March 2020. Fried Frailty Phenotype (FFP) was used to test frailty. Clinical Frailty Scale, Grip Strength, Montreal Cognitive Assessment, Timed Up and Go, Geriatric Depression Scale and selfreported: mobility status, caregiving status, number of falls and number of hospital admissions were also assessed to describe the population. Data were analysed using SPSS.

Results: Data from 27 dyads that participated and consented were analysed. A total of 15 patients (55.5%) and four spouses (14.8%) were classified as frail. Of 15 frail patients, four had frail spouses, five had pre-frail spouses and six had robust spouses. No pre-frail or robust patients had frail spouses. Spearman’s Correlational analysis showed no correlation in FFP between patient and spouse (r=0.24, p=0.23). Participants that classed themselves as caregivers (44.4%) accounted for five patients (frail n=4) and 19 spouses (frail n=4).

Conclusion: Frailty in dyads is heterogeneous. Caregivers are commonly frail and provide care to frail partners. Older adults admitted to hospital should be assessed for frailty. If the patient has a spouse, especially if the patient is frail, their spouse should be assessed for frailty.