R C Oude Voshaar1,2, H W Jeuring3, M K Borges4, R H S van den Brink3, R M Marijnissen3, E O Hoogendijk5, B van Munster6, I Aprahamian3,7. 1. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. r.c.oude.voshaar@umcg.nl. 2. Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil. r.c.oude.voshaar@umcg.nl. 3. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil. 5. Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 7. Geriatrics division, Internal Medicine Department, Faculty of Medicine of Jundiaí, Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Jundiaí, Brazil.
Abstract
BACKGROUND: The frailty index (FI) is a well-recognized measurement for risk stratification in older people. Among middle-aged and older people, we examined the prospective association between the FI and mortality as well as its course over time in relation to multimorbidity and specific disease clusters. METHODS: A frailty index (FI) was constructed based on either 64 (baseline only) or 35 health deficits (baseline and follow-up) among people aged ≥ 40 years who participated in LifeLines, a prospective population-based cohort living in the Northern Netherlands. Among 92,640 participants, multivariable Cox proportional hazard models were fitted to study the hazard ratio (HR) of the FI at baseline, as well as for 10 chronic disease clusters for all-cause mortality over a 10-year follow-up. Among 55,426 participants, linear regression analyses were applied to study the impact of multimorbidity and of specific chronic disease clusters (independent variables) on the change of frailty over a 5-year follow-up, adjusted for demographic and lifestyle characteristics. RESULTS: The FI predicted mortality independent of multimorbidity and specific disease clusters, with the highest impact in people with either endocrine, lung, or heart diseases. Adjusted for demographic and lifestyle characteristics, all chronic disease clusters remained independently associated with an accelerated increase of frailty over time. CONCLUSIONS: Frailty may be seen as a final common pathway for premature death due to chronic diseases. Our results suggest that initiating frailty prevention at middle age, when the first chronic diseases emerge, might be relevant from a public health perspective.
BACKGROUND: The frailty index (FI) is a well-recognized measurement for risk stratification in older people. Among middle-aged and older people, we examined the prospective association between the FI and mortality as well as its course over time in relation to multimorbidity and specific disease clusters. METHODS: A frailty index (FI) was constructed based on either 64 (baseline only) or 35 health deficits (baseline and follow-up) among people aged ≥ 40 years who participated in LifeLines, a prospective population-based cohort living in the Northern Netherlands. Among 92,640 participants, multivariable Cox proportional hazard models were fitted to study the hazard ratio (HR) of the FI at baseline, as well as for 10 chronic disease clusters for all-cause mortality over a 10-year follow-up. Among 55,426 participants, linear regression analyses were applied to study the impact of multimorbidity and of specific chronic disease clusters (independent variables) on the change of frailty over a 5-year follow-up, adjusted for demographic and lifestyle characteristics. RESULTS: The FI predicted mortality independent of multimorbidity and specific disease clusters, with the highest impact in people with either endocrine, lung, or heart diseases. Adjusted for demographic and lifestyle characteristics, all chronic disease clusters remained independently associated with an accelerated increase of frailty over time. CONCLUSIONS: Frailty may be seen as a final common pathway for premature death due to chronic diseases. Our results suggest that initiating frailty prevention at middle age, when the first chronic diseases emerge, might be relevant from a public health perspective.
Authors: Salome Scholtens; Nynke Smidt; Morris A Swertz; Stephan J L Bakker; Aafje Dotinga; Judith M Vonk; Freerk van Dijk; Sander K R van Zon; Cisca Wijmenga; Bruce H R Wolffenbuttel; Ronald P Stolk Journal: Int J Epidemiol Date: 2014-12-14 Impact factor: 7.196
Authors: Karen Barnett; Stewart W Mercer; Michael Norbury; Graham Watt; Sally Wyke; Bruce Guthrie Journal: Lancet Date: 2012-05-10 Impact factor: 79.321
Authors: Emma Raymond; Chandra A Reynolds; Anna K Dahl Aslan; Deborah Finkel; Malin Ericsson; Sara Hägg; Nancy L Pedersen; Juulia Jylhävä Journal: J Gerontol A Biol Sci Med Sci Date: 2020-09-25 Impact factor: 6.053
Authors: Rathi Ravindrarajah; David M Lee; Stephen R Pye; Evelien Gielen; Steven Boonen; Dirk Vanderschueren; Neil Pendleton; Joseph D Finn; Abdelouahid Tajar; Matthew D L O'Connell; Kenneth Rockwood; György Bartfai; Felipe F Casanueva; Gianni Forti; Aleksander Giwercman; Thang S Han; Ilpo T Huhtaniemi; Krzysztof Kula; Michael E J Lean; Margus Punab; Frederick C W Wu; Terence W O'Neill Journal: Arch Gerontol Geriatr Date: 2013-07-18 Impact factor: 3.250
Authors: M K Borges; C V Romanini; N A Lima; M Petrella; D L da Costa; V N An; B N Aguirre; J R Galdeano; I C Fernandes; J F Cecato; E C Robello; R C Oude Voshaar; I Aprahamian Journal: J Nutr Health Aging Date: 2021 Impact factor: 4.075
Authors: Ivan Aprahamian; Marcus K Borges; Denise J C Hanssen; Hans W Jeuring; Richard C Oude Voshaar Journal: Clin Interv Aging Date: 2022-06-22 Impact factor: 3.829