Subtypes of physical frailty: Latent class analysis and associations with clinical characteristics and outcomes

Abstract

Frailty is a well-recognized geriatric syndrome with various definitions and conceptual frameworks. This study aimed to use latent class analysis to discover potential subtypes of pre-frail and frail older people. Data from the I-Lan Longitudinal Aging Study (ILAS), a community-based cohort study was used for analysis. Latent class analysis was applied to characterize classes or subgroups with different frailty phenotypes among ILAS participants targeting older adults aged 65 and above, capable of completing a 6-meter walk, without severe major or life threatening diseases, and not institutionalized. Latent class analysis identified three distinct subgroups with different frailty phenotypes: non-mobility-type (weight loss and exhaustion), mobility-type frailty (slowness and weakness), and low physical activity. Comparing these groups with the robust group, people with mobility-type frailty had poorer body composition, worse bone health, poorer cognitive function, lower survival (hazard ratio: 6.82, p = 0.019), and poorer overall health outcomes (hazard ratio: 1.67, p = 0.040). People in the non-mobility-type group had poorer bone health and more metabolic serum abnormalities. In conclusion, mobility-type frailty was a better predictor of adverse outcomes. However, further investigation is needed to evaluate how these phenotypic subgroups may help in predicting prognosis or in developing interventions.

Links Between Physical Frailty and Regional Gray Matter Volumes in Older Adults: A Voxel-Based Morphometry Study

“…28 They might present as mobility-type frailty, which are the core determinants of physical frailty and sarcopenia as well as significant predictors of adverse clinical outcomes. 7,[29][30][31] Recent research has recommended using weakness and slowness as diagnostic criteria of cognitive frailty. 32,33 The current results also suggest the importance of weakness and slowness in relation to changes in brain structures.…”

“…The results of this analysis indicated that the association of weakness and slowness with the brain volume was more significant when both weakness and slowness was observed than either weakness or slowness (Supplementary Figure 5). Therefore, mobility-type frailty 29 might be most closely associated with regional brain volumes.…”

Association between sarcopenia and osteoporosis in chronic liver disease

“…7 This condition is associated with mortality in patients with end-stage liver disease. 8 Early diagnosis and prevention of osteoporosis is needed in CLD patients.…”

Precision geriatrics: Comprehensiveness and individualization for frailty intervention

“…A recent report proposed that physical frailty may be classified into mobility and non-mobility subtypes, and differences in clinical characteristics and mortality between frailty subtypes have been clearly shown. 19 Moreover, mobility subtype frailty is associated with cognitive declines in non-memory domains, mainly executive function. 20,21 Brain imaging of the same cohort revealed significantly reduced cerebellar gray matter among pre-frail and frail older adults, 22 especially those with mobility subtype frailty.…”