Sepsis accelerates frailty and functional decline in older adults: a 12-month prospective study

Sepsis, a life-threatening infection-induced condition, is a leading cause of mortality worldwide, particularly among older adults. Survivors often experience long-term health complications, including decline in functional capacity, cognitive impairment, and worsening of chronic comorbidities. This study aimed to evaluate the impact of sepsis on frailty and functional status over 12 months in patients with community-acquired infections. 50 patients completed the follow-up and were analyzed: 24 in the sepsis group and 26 in the control group, matched by age, sex, and infection source. Functional status was assessed at baseline and 12 months using the Barthel Index, Lawton Scale, and FRAIL questionnaire. At 12 months, septic patients showed significant declines in both functional capacity and frailty. Specifically, there was a significant decline in functional independence as measured by the Lawton Scale, with 33.3% of septic patients exhibiting reduced ability in instrumental activities of daily living, compared to 11.7% in controls (p = 0.032). FRAIL scale showed significant worsening in the sepsis group (41.7% vs. 7.7%, p = 0.005). Notably, 33.3% of previously robust septic patients developed new frailty, compared to 0% in the control group (p = 0.025). The study also found a significant increase in comorbidity burden at 12 months within the sepsis group (p = 0.041), whereas between-group differences were not statistically significant. These results highlight the long-term impact of sepsis on functional capacity and frailty, emphasizing the need for targeted post-sepsis rehabilitation and management.