Rebecca S Crow1,2,3, Matthew C Lohman3,4, Alexander J Titus2,5, Martha L Bruce2,3,4, Todd A Mackenzie2,6,7, Stephen J Bartels2,3,4,7, John A Batsis1,2,3,4,7,8. 1. Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. 2. Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire. 3. Dartmouth Centers for Health and Aging, Dartmouth College, Hanover, New Hampshire. 4. Health Promotion Research Center at Dartmouth, Dartmouth College, Lebanon, New Hampshire. 5. Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire. 6. Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire. 7. Dartmouth Institute for Health Policy and Clinical Research, Lebanon, New Hampshire. 8. Dartmouth Weight & Wellness Center, Lebanon, New Hampshire.
Abstract
OBJECTIVES: To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN: Longitudinal mortality analysis. SETTING: National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS: Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% female). MEASUREMENTS: We used data from 1999-2004 cross-sectional NHANES and mortality data from the National Death Index, updated through December 2011. An adapted version of Fried's frailty criteria was used (low body mass index, slow walking speed, weakness, exhaustion, low physical activity). Frailty was defined as persons meeting 3 or more criteria, prefrailty as meeting 1 or 2 criteria, and robust (reference) as not meeting any criteria. The primary outcome was to evaluate the association between frailty and overall and cardiovascular mortality. Cox proportional hazard models were used to evaluate the association between risk of death and frailty category adjusted for age, sex, race, smoking, education, coronary artery disease, heart failure, nonskin cancer, diabetes, and arthritis. RESULTS: Half (50.4%) of participants were classified as robust, 40.3% as prefrail, and 9.2% as frail. Fully adjusted models demonstrated that prefrail (hazard ratio (HR) = 1.64, 95% confidence interval (CI) = 1.45-1.85) and frail (HR = 2.79, 95% CI = 2.35-3.30) participants had a greater risk of death and of cardiovascular death (prefrail: HR = 1.84, 95% CI = 1.45-2.34; frail: HR = 3.39, 95% CI = 2.45-4.70). CONCLUSION: Frailty and prefrailty are associated with increased risk of death. Demonstrating the association between prefrail status and mortality is the first step to identifying potential targets of intervention in future studies.
OBJECTIVES: To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN: Longitudinal mortality analysis. SETTING: National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS: Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% female). MEASUREMENTS: We used data from 1999-2004 cross-sectional NHANES and mortality data from the National Death Index, updated through December 2011. An adapted version of Fried's frailty criteria was used (low body mass index, slow walking speed, weakness, exhaustion, low physical activity). Frailty was defined as persons meeting 3 or more criteria, prefrailty as meeting 1 or 2 criteria, and robust (reference) as not meeting any criteria. The primary outcome was to evaluate the association between frailty and overall and cardiovascular mortality. Cox proportional hazard models were used to evaluate the association between risk of death and frailty category adjusted for age, sex, race, smoking, education, coronary artery disease, heart failure, nonskin cancer, diabetes, and arthritis. RESULTS: Half (50.4%) of participants were classified as robust, 40.3% as prefrail, and 9.2% as frail. Fully adjusted models demonstrated that prefrail (hazard ratio (HR) = 1.64, 95% confidence interval (CI) = 1.45-1.85) and frail (HR = 2.79, 95% CI = 2.35-3.30) participants had a greater risk of death and of cardiovascular death (prefrail: HR = 1.84, 95% CI = 1.45-2.34; frail: HR = 3.39, 95% CI = 2.45-4.70). CONCLUSION: Frailty and prefrailty are associated with increased risk of death. Demonstrating the association between prefrail status and mortality is the first step to identifying potential targets of intervention in future studies.
Authors: Melissa J Azur; Elizabeth A Stuart; Constantine Frangakis; Philip J Leaf Journal: Int J Methods Psychiatr Res Date: 2011-03 Impact factor: 4.035
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Edward Chong; Esther Ho; Jewel Baldevarona-Llego; Mark Chan; Lynn Wu; Laura Tay Journal: J Am Med Dir Assoc Date: 2017-06-03 Impact factor: 4.669
Authors: Guowei Li; Lehana Thabane; George Ioannidis; Courtney Kennedy; Alexandra Papaioannou; Jonathan D Adachi Journal: PLoS One Date: 2015-03-12 Impact factor: 3.240
Authors: Jens-Oliver Bock; Hans-Helmut König; Hermann Brenner; Walter E Haefeli; Renate Quinzler; Herbert Matschinger; Kai-Uwe Saum; Ben Schöttker; Dirk Heider Journal: BMC Health Serv Res Date: 2016-04-14 Impact factor: 2.655
Authors: Shawna Amini; Samuel Crowley; Loren Hizel; Franchesca Arias; David J Libon; Patrick Tighe; Chris Giordano; Cynthia W Garvan; F Kayser Enneking; Catherine C Price Journal: Anesth Analg Date: 2019-09 Impact factor: 5.108
Authors: R S Crow; M C Lohman; A J Titus; S B Cook; M L Bruce; T A Mackenzie; S J Bartels; J A Batsis Journal: J Nutr Health Aging Date: 2019 Impact factor: 4.075
Authors: Matthew C Lohman; Amanda J Sonnega; Nicholas V Resciniti; Amanda N Leggett Journal: J Gerontol A Biol Sci Med Sci Date: 2020-09-25 Impact factor: 6.053
Authors: Jennifer L Guida; Tim A Ahles; Daniel Belsky; Judith Campisi; Harvey Jay Cohen; James DeGregori; Rebecca Fuldner; Luigi Ferrucci; Lisa Gallicchio; Leonid Gavrilov; Natalia Gavrilova; Paige A Green; Chamelli Jhappan; Ronald Kohanski; Kevin Krull; Jeanne Mandelblatt; Kirsten K Ness; Ann O'Mara; Nathan Price; Jennifer Schrack; Stephanie Studenski; Olga Theou; Russell P Tracy; Arti Hurria Journal: J Natl Cancer Inst Date: 2019-12-01 Impact factor: 13.506
Authors: Rebecca S Crow; Christian Haudenschild; Matthew C Lohman; Robert M Roth; Meredith Roderka; Travis Masterson; John Brand; Tyler Gooding; Todd A Mackenzie; John A Batsis Journal: J Am Geriatr Soc Date: 2021-02-10 Impact factor: 5.562