Frailty-related Risk Factors: A prevalence study in older adults seen by community nurses in Dublin, Ireland

This paper describes the frequency of four frailty-related risk factors in a cohort of older adults visited by community nurses in Dublin, Ireland. The Irish public health nursing (PHN) service maintains an open referral process with clients either self-referred or referred by health professionals. The risk factors examined were: suspected cognitive impairment, nutritional and fall risk and ADL dependence. The study incorporated a retrospective clinical audit of community nursing files (N=120). A chi-square analysis tested for association between each risk factor and oldest age, living alone, professional referral to the nursing service and presence of formal home support. Findings revealed a cohort prevalence of suspected cognitive impairment of 16.4%. Risk of malnutrition and risk of a fall were 20.2% and 30.8% respectively. The cohort was dependent in ADL at a rate of 23.5%. Participants dependent in ADL (p=0.00) were less likely to live alone and were more likely to have referred themselves to community nursing (p= 0.04). Associations between the four frailty-related risk factors and receiving home support were not significant (p=>0.05). The study results suggest that dependency in ADL (an outcome of frailty) is strongly associated with a decreased likelihood of living alone as well as increased likelihood of referring oneself to community nursing services in Dublin, Ireland. A policy of self referral facilitates older adults who are dependent in ADL care. Further research is necessary to establish the barriers for those living with ADL dependence in the community (especially alone) if equitable service delivery is to be achieved.