Mark Q Thompson1,2, Olga Theou1,2,3, Graeme R Tucker2, Robert J Adams4, Renuka Visvanathan1,2. 1. National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia. 2. Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia. 3. Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 4. The Health Observatory, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia.
Abstract
OBJECTIVES: Frailty places individuals at greater risk of adverse health outcomes. However, it is a dynamic condition and may not always lead to decline. Our objective was to determine the relationship between frailty status (at baseline and follow-up) and mortality using both the frailty phenotype (FP) and frailty index (FI). DESIGN: Population-based cohort. SETTING: Community-dwelling older adults. PARTICIPANTS: A total of 909 individuals aged 65 years or older (55% female), mean age 74.4 (SD 6.2) years, had frailty measurement at baseline. Overall, 549 participants had frailty measurement at two time points. MEASUREMENTS: Frailty was measured using the FP and FI, with a mean 4.5 years between baseline and follow-up. Mortality was matched to official death records with a minimum of 10 years of follow-up. RESULTS: For both measures, baseline frailty was a significant predictor of mortality up to 10 years, with initially good predictive ability (area under the curve [AUC] = .8-.9) decreasing over time. Repeated measurement at follow-up resulted in good prediction compared with lower (AUC = .6-.7) discrimination of equivalent baseline frailty status. In a multivariable model, frailty measurement at follow-up was a stronger predictor of mortality compared with baseline. Frailty change for the Continuous FI was a significant predictor of decreased or increased mortality risk based on corresponding improvement or worsening of score (hazard ratio = 1.04; 95% confidence interval = 1.02-1.07; P = .001). CONCLUSIONS: Frailty measurement is a good predictor of mortality up to 10 years; however, recency of frailty measurement is important for improved prediction. A regular review of frailty status is required in older adults. J Am Geriatr Soc 67:2311-2317, 2019.
OBJECTIVES: Frailty places individuals at greater risk of adverse health outcomes. However, it is a dynamic condition and may not always lead to decline. Our objective was to determine the relationship between frailty status (at baseline and follow-up) and mortality using both the frailty phenotype (FP) and frailty index (FI). DESIGN: Population-based cohort. SETTING: Community-dwelling older adults. PARTICIPANTS: A total of 909 individuals aged 65 years or older (55% female), mean age 74.4 (SD 6.2) years, had frailty measurement at baseline. Overall, 549 participants had frailty measurement at two time points. MEASUREMENTS: Frailty was measured using the FP and FI, with a mean 4.5 years between baseline and follow-up. Mortality was matched to official death records with a minimum of 10 years of follow-up. RESULTS: For both measures, baseline frailty was a significant predictor of mortality up to 10 years, with initially good predictive ability (area under the curve [AUC] = .8-.9) decreasing over time. Repeated measurement at follow-up resulted in good prediction compared with lower (AUC = .6-.7) discrimination of equivalent baseline frailty status. In a multivariable model, frailty measurement at follow-up was a stronger predictor of mortality compared with baseline. Frailty change for the Continuous FI was a significant predictor of decreased or increased mortality risk based on corresponding improvement or worsening of score (hazard ratio = 1.04; 95% confidence interval = 1.02-1.07; P = .001). CONCLUSIONS: Frailty measurement is a good predictor of mortality up to 10 years; however, recency of frailty measurement is important for improved prediction. A regular review of frailty status is required in older adults. J Am Geriatr Soc 67:2311-2317, 2019.
Authors: M Sofia Massa; Robert Clarke; Derrick Bennett; Dani J Kim; Siobhan Scarlett; Aisling M O'Halloran; Rose Anne Kenny Journal: Sci Rep Date: 2022-03-22 Impact factor: 4.379
Authors: Rachel E Ward; Ariela R Orkaby; Clark Dumontier; Brian Charest; Chelsea E Hawley; Enzo Yaksic; Lien Quach; Dae H Kim; David R Gagnon; J Michael Gaziano; Kelly Cho; Luc Djousse; Jane A Driver Journal: J Gerontol A Biol Sci Med Sci Date: 2021-10-13 Impact factor: 6.591