Clinical Frailty Scale and 12-month adverse health outcomes among community-dwelling older adults in Vietnam: a prospective cohort study

Abstract

Background Frailty is an important predictor of adverse health outcomes in older adults, but evidence from community settings in Vietnam remains limited. This study examined the association between frailty and adverse health outcomes among community-dwelling older adults. Methods In this prospective cohort study, 1,208 community-dwelling older adults were assessed using the Clinical Frailty Scale (CFS) and followed for 12 months. The primary outcome was a composite of all-cause mortality, falls, and hospitalization. Multivariable logistic regression was used to evaluate the independent association between frailty and adverse outcomes. Results Of the participants, 59.9% were robust, 7.8% vulnerable, 31.2% had mild-to-moderate frailty, and 1.2% had severe frailty. During follow-up, 23.6% experienced at least one adverse outcome. Event rates increased progressively across frailty categories, from 9.7% in robust participants to 64.3% in those with severe frailty (P for trend <0.001). After adjustment for demographic characteristics, lifestyle factors, multimorbidity, polypharmacy, and cognitive impairment, frailty remained independently associated with adverse outcomes (adjusted OR per one-point increase in CFS: 1.88, 95% CI: 1.67–2.11; P < 0.001). Conclusion Frailty was highly prevalent and strongly associated with adverse health outcomes among community-dwelling older adults. These findings support the use of the Clinical Frailty Scale to identify community-dwelling older adults who may benefit from closer monitoring and targeted preventive care.