Relationship between frailty assessment and functional status in older adults in Mongolia

The purpose of this study, a joint research project between Japan and Mongolia, was to evaluate the functional status of older Mongolian adults and to clarify its relationship with frailty as determined by the Kihon Check list.

This cross-sectional study was approved by the Ethics Committee of Fukushima Medical University (Approval No. REC2023-064). The subjects were 72 people aged 65 years and older (54 women, 18 men) living in Ulaanbaatar and Mandalgovi, Mongolia. Kihon check list, hand grip strength, knee extension strength, five repetition sit-to-stand test (SS-5), single leg standing time (SLST), hip and trunk flexion flexibility, Perdue Pegbord test, oral diadchokinesis, repeated saliva swallow test, tongue pressure, 10m walk test (10MWT), and timed up & go test (TUG) were measured for all participants.  Based on the results of the Kihon check list, we defined frailty as a score of 8 to 25, pre-frailty as a score of 4 to 7, and the healthy group as a score of 3 or less. For items with normal distribution, we used Pearson's correlation coefficient, and for items without normal distribution, we used Spearman's rank correlation coefficient. In addition, for intergroup comparisons between the frail, pre-frail, and healthy groups, one-way analysis of variance was used for items with normal distribution, and Kruskal-Wallis test was used for items without normal distribution, with Bonfferoni test for post hoc testing. 

62 subjects completed the measurements, of which 26 were frail, 26 were pre-frail, and 10 were healthy. There were significant correlations between the Kihon check list and knee extension strength (r=-0.363, p0.01), SS-5 (r=-0.400, p0.01), SLST (r=-0.454, p0.01), 10MWT (r=-0.424, p0.01), and TUG (r=0.398, p0.01). Significant differences were found between the groups for knee extension strength, SS-5, SLST, Perdue pegboard test, 10MWT, and TUG. The frail group had significantly worse function than the healthy group in all items.

This study suggests that there are elderly people in the target population who are in a constant state of frailty or pre-frailty. There was a relationship between the Kihon check list, which is used to assess frailty, and functional ability, and it was clear that people who were classified as frail had decreased functional ability.

It is necessary for physical therapists in Mongolia to prevent frailty, based on the results of this study as well as continuing with the survey. As part of their role as physical therapists in Mongolia, it is important that they carry out appropriate assessments and approach the maintenance and improvement of lower limb muscle strength, standing balance, manual dexterity and walking ability.