Several frailty parameters highly prevalent in middle age (50–65) are independent predictors of adverse events

Abstract

Although frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.

Using EHR Data to Identify Patient Frailty and Risk for ICU Transfer

“…First, we found that the effect of frailty on time to first ICU transfer depended on the patient’s age. Although study findings, whereby the average FRS score for each FRS definition significantly increased with age and confirms the increased prevalence of frailty in older adults (Chu et al, 2021; Segaux et al, 2021), the current study found the highest prevalence (using FRS-NF-26-LABS) in the 60 to <70 years age group (56.4%) and not the oldest ≥80 years age group (43.5%).…”

“…The present study contributes new information on frailty in hospitalized middle-aged adults (Segaux et al, 2021) and adds to the frailty literature that has primarily addressed older adults 65 or 70 years of age and older based on conceptions of frailty as a geriatric syndrome. Our findings and others (Hanlon et al, 2018; Loecker et al, 2021; Segaux et al, 2021) confirm the importance of assessing frailty in middle-aged adults since this group is not typically considered at risk for frailty and may be overlooked in frailty risk stratification. Contemporary aging theories and research recognize heterogeneity in the aging process and the influence of behaviors, comorbidity, the social environment, and social determinants on health status with negative consequences such as frailty (Buta et al, 2016).…”

Machine learning for predicting readmission risk among the frail: Explainable AI for healthcare

“…Since many frailty parameters are already altered in middle age and predictive of adverse events, restricting frailty assessment to older age groups overlooks the needs of this vulnerable population and opportunities for prevention and risk mitigation. 63 , 64 , 65 Prior research using the FRS showed a weak effect size for age and FRS scores. 8 , 9 …”

Exploring the Relationship between Frailty, Functional Status, Polypharmacy, and Quality of Life in Elderly and Middle-Aged Patients with Cardiovascular Diseases: A One-Year Follow-Up Study

“…Due to the negative health outcomes associated with frailty, routine screening and studies have been applied and recommended to populations aged over 65 years [ 11 , 12 , 13 , 14 , 15 ], but there is limited data available regarding middle-aged populations (45–65 years old) or those younger than 45 years old [ 16 , 17 ].…”