Matthew C Lohman1, Amanda J Sonnega2, Nicholas V Resciniti1, Amanda N Leggett3,4. 1. Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia. 2. Institute for Social Research, University of Michigan, Ann Arbor. 3. Department of Psychiatry, University of Michigan, Ann Arbor. 4. Institute for Health Policy and Innovation, University of Michigan, Ann Arbor.
Abstract
BACKGROUND: Frailty is a common condition among older adults increasing risk of adverse outcomes including mortality; however, little is known about the incidence or risk of specific causes of death among frail individuals. METHODS: Data came from the Health and Retirement Study (HRS; 2004-2012), linked to underlying cause-of-death information from the National Death Index (NDI). Community-dwelling HRS participants aged 65 and older who completed a general health interview and physical measurements (n = 10,490) were included in analysis. Frailty was measured using phenotypic model criteria-exhaustion, low weight, low energy expenditure, slow gait, and weakness. Underlying causes of death were determined using International Classification of Diseases, Version 10 codes. We used Cox proportional hazards and competing risks regression models to calculate and compare incidence of cause-specific mortality by frailty status. RESULTS: During follow-up, prefrail and frail older adults had significantly greater hazard of all-cause mortality compared to individuals without symptoms (adjusted hazard ratio [HR] prefrail: 1.85, 95% CI: 1.51, 2.25; HR frail: 2.75, 95% CI: 2.14, 3.53). Frailty was associated with 2.96 (95% CI: 2.17, 4.03), 2.82 (95% CI: 2.02, 3.94), 3.48 (95% CI: 2.17, 5.59), and 2.87 (95% CI: 1.47, 5.59) times greater hazard of death from heart disease, cancer, respiratory illness, and dementia, respectively. CONCLUSIONS: Significantly greater risk of mortality from several different causes should be considered alongside the potential costs of screening and intervention for frailty in subspecialty and general geriatric clinical practice. Findings may help investigators estimate the potential impact of frailty reduction approaches on mortality.
BACKGROUND: Frailty is a common condition among older adults increasing risk of adverse outcomes including mortality; however, little is known about the incidence or risk of specific causes of death among frail individuals. METHODS: Data came from the Health and Retirement Study (HRS; 2004-2012), linked to underlying cause-of-death information from the National Death Index (NDI). Community-dwelling HRSparticipants aged 65 and older who completed a general health interview and physical measurements (n = 10,490) were included in analysis. Frailty was measured using phenotypic model criteria-exhaustion, low weight, low energy expenditure, slow gait, and weakness. Underlying causes of death were determined using International Classification of Diseases, Version 10 codes. We used Cox proportional hazards and competing risks regression models to calculate and compare incidence of cause-specific mortality by frailty status. RESULTS: During follow-up, prefrail and frail older adults had significantly greater hazard of all-cause mortality compared to individuals without symptoms (adjusted hazard ratio [HR] prefrail: 1.85, 95% CI: 1.51, 2.25; HR frail: 2.75, 95% CI: 2.14, 3.53). Frailty was associated with 2.96 (95% CI: 2.17, 4.03), 2.82 (95% CI: 2.02, 3.94), 3.48 (95% CI: 2.17, 5.59), and 2.87 (95% CI: 1.47, 5.59) times greater hazard of death from heart disease, cancer, respiratory illness, and dementia, respectively. CONCLUSIONS: Significantly greater risk of mortality from several different causes should be considered alongside the potential costs of screening and intervention for frailty in subspecialty and general geriatric clinical practice. Findings may help investigators estimate the potential impact of frailty reduction approaches on mortality.
Authors: Igor Grabovac; Sandra Haider; Christina Mogg; Barbara Majewska; Deborah Drgac; Moritz Oberndorfer; Thomas E Dorner Journal: J Am Med Dir Assoc Date: 2019-07-24 Impact factor: 4.669
Authors: Yves Rolland; Charlotte Dupuy; Gabor Abellan van Kan; Sophie Gillette; Bruno Vellas Journal: Med Clin North Am Date: 2011-03-30 Impact factor: 5.456
Authors: Ian D Cameron; Nicola Fairhall; Colleen Langron; Keri Lockwood; Noeline Monaghan; Christina Aggar; Catherine Sherrington; Stephen R Lord; Susan E Kurrle Journal: BMC Med Date: 2013-03-11 Impact factor: 8.775
Authors: Matthew C Lohman; Briana Mezuk; Amanda J Fairchild; Nicholas V Resciniti; Anwar T Merchant Journal: Aging Ment Health Date: 2021-07-11 Impact factor: 3.514
Authors: Nada Almohaisen; Matthew Gittins; Chris Todd; Jana Sremanakova; Anne Marie Sowerbutts; Amal Aldossari; Asrar Almutairi; Debra Jones; Sorrel Burden Journal: Nutrients Date: 2022-04-07 Impact factor: 6.706