Subjective memory complaints, prefrailty and frailty: Most prevalent geriatric syndromes in HK

Subjective memory complaints, prefrailty and frailty are the most prevalent geriatric syndromes in older individuals in Hong Kong, according to local data presented at AIM 2024.

Geriatric syndromes are multifactorial conditions commonly found in older adults. [Am Soc Clin Oncol Educ Book 2019:39;e96-e109] In Hong Kong, an electronic well-being survey of 17,521 older individuals (mean age, 74.4 years; female, 79.4 percent; living alone, 31.6 percent) showed that the most commonly reported geriatric syndromes were subjective memory complaints (78.7 percent) and prefrailty/frailty (62.0 percent). [Woo J, AIM 2024]

“While these geriatric syndromes were as prevalent as hypertension [64.5 percent] and high cholesterol levels [50.7 percent], in clinical practice, geriatric syndromes are often ignored and remain an unaddressed need among older individuals,” pointed out Professor Jean Woo of the Department of Medicine and Therapeutics, the Chinese University of Hong Kong.

Geriatric syndromes can significantly impact older individuals’ health and healthcare utilization. A study of older community-dwelling individuals in Hong Kong showed that at 1-year follow-up, the presence of subjective memory complaints, prefrailty or frailty at baseline was significantly associated with increased risks of disability in instrumental activities of daily living and incident hospitalization (p<0.001 for all). [Woo J, AIM 2024]

Moreover, multivariate regression models demonstrated that older people with a higher degree of frailty required more frequent hospitalization, specialist outpatient clinic visits, general outpatient clinical visits and daycare services.

“However, frailty is not an inevitable part of ageing. It is treatable, and physical frailty can be reversed,” highlighted Woo.

Integrated care intervention

To enhance primary care for prefrail and frail older individuals, Woo and colleagues implemented an integrated care intervention comprising frailty assessment, personalized care plans, and coordinated care services. A quasi-experimental study including 453 prefrail or frail older people (mean age, 76.1 years; female, 80.1 percent) recruited across 38 seniors’ centres showed that after 1-year follow-up, participants receiving the integrated care intervention (n=183) were more likely to revert to robust status than those attending a group-based education session on frailty prevention (n=270) (22.4 vs 13.7 percent), with a significant between-group difference after adjustment (odds ratio, 1.6). These findings provide evidence supporting the integrated care model for preventing frailty in the community setting. [Age Ageing 2020;49:1048-1055]

“Certain evidence-based programmes [consisting of video games or exercise courses] may also improve cognitive or physical function among older individuals,” Woo added.

iHealth Screen

iHealth Screen is a free self-help mobile health app developed by Woo and colleagues for older adults and caregivers. The app covers 11 common health topics (eg, frailty, memory) and provides geriatric assessments, test results, educational videos, information on community resources, and a comprehensive health report. Users can perform health screening tests through its interactive interface. [Wong M, et al, AGen 2024; https://www.cadenza.hk/e-tools/en/ihealthscreen/]

“iHealth Screen is a user-friendly tool for older individuals and caregivers to conduct health screening anytime. It allows users to monitor their health and seek professional advice as needed. With technology support, this approach may promote healthy ageing and enhance quality of life of older individuals,” said Woo.

“Be prepared, we are all going to live 100 [years] and more,” she concluded.