Prevalence and 10‐Year Outcomes of Frailty in Older Adults in Relation to Deficit Accumulation

Abstract

OBJECTIVES:To evaluate the prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. DESIGN: Prospective cohort study. SETTING: The National Population Health Survey of Canada, with frailty estimated at baseline (1994/95) and mortality follow-up to 2004/05. PARTICIPANTS: Community-dwelling older adults (N 5 2,740, 60.8% women) aged 65 to 102 from 10 Canadian provinces. During the 10-year follow-up, 1,208 died. MEASUREMENTS: Self-reported health information was used to construct a frailty index (Frailty Index) as a proportion of deficits accumulated in individuals. The main outcome measure was mortality. RESULTS: The prevalence of frailty increased with age in men and women (correlation coefficient 5 0.955-0.994, Po.001). The Frailty Index estimated that 622 (22.7%, 95% confidence interval (CI) 5 21.0-24.4%) of the sample was frail. Frailty was more common in women (25.3%, 95% CI 5 23.2-27.5%) than in men (18.6%, 95% CI 5 15.9-21.3%). For those aged 85 and older, the Frailty Index identified 39.1% (95% CI 5 31.3-46.9%) of men as frail, compared with 45.1% (95% CI 5 39.7-50.5%) of women. Frailty significantly increased the risk of death, with an age-and sex-adjusted hazard ratio for the Frailty Index of 1.57 (95% CI 5 1.41-1.74). CONCLUSION: The prevalence of frailty increases with age and at any age lessens survival. The Frailty Index approach readily identifies frail people at risk of death, presumably because of its use of multiple health deficits in multidimensional domains. J Am Geriatr Soc 58:681-687, 2010.

Frailty, depression, and anxiety in later life

“…Regarding mortality, our results are consistent with previous studies showing that at all ages, a higher FI was associated with higher mortality [13,24], and that the FI predicts death better than chronological age [22]. In the Chinese Longitudinal Healthy Longevity Survey, the FI was a robust predictor of mortality at advanced ages and the relationship between frailty and mortality was independent of age and other covariates [25].…”

“…Thirty-nine variables had the recommended <5% of missing data [13]. Grip strength had 10.1% of missing data, but it was retained as it is known to be an important objective marker of frailty [14,15].…”

“…Grip strength had 10.1% of missing data, but it was retained as it is known to be an important objective marker of frailty [14,15]. As done by others [13], missing values for each variable were imputed using the non-missing mean of the variable. The correlation between the original FI and the imputed FI was extremely high (adjusted linear R 2 = 0.99, P < 0.001), so the original one was used.…”

Association of midlife obesity and cardiovascular risk with old age frailty: a 26-year follow-up of initially healthy men

“…As an important predictor of disability, institutionalization and death, [1][2][3][4][5][6][7][8][9][10] old age frailty will rise to a public health issue of remarkable proportions during the coming decades. Although no strict consensus criteria have been established to date, 2,7 the phenotypic criteria described by Fried et al 1 are commonly used to define frailty as a geriatric syndrome characterized by excess vulnerability, loss of resiliency and multi-system decline.…”

Predictive Risk Modelling for Integrated Care: A Structured Review

“…Also, it has been shown that more manageable 30 parameters of FI model [45], simpler models with minimal overlap in identification [46] or existing electronic health record data can have competitive predictive validity [44].…”