The accumulation of deficits approach to describe frailty

Abstract

The advancing age of the participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)—Potsdam study was the incentive to investigate frailty as a major parameter of ageing. The aim of this study was to develop a multidimensional tool to measure frailty in an ageing, free-living study population. The “accumulation of deficits approach” was used to develop a frailty index (FI) to characterize a sub-sample (N = 815) of the EPIC-Potsdam (EPIC-P) study population regarding the aging phenomenon. The EPIC-P frailty index (EPIC-P-FI) included 32 variables from the following domains: health, physical ability, psychosocial and physiological aspects. P–values were calculated for the linear trend between sociodemographic and life style variables and the EPIC-P-FI was calculated using regression analysis adjusted for age. The relationship between the EPIC-P-FI and age was investigated using fractional polynomials. Some characteristics such as age, education, time spent watching TV, cycling and a biomarker of inflammation (C-reactive protein) were associated with frailty in men and women. Interestingly, living alone, having no partner and smoking status were only associated with frailty in men, and alcohol use and physical fitness (VO2max) only in women. The generated, multidimensional FI, adapted to the EPIC-P study, showed that this cohort is a valuable source for further exploration of factors that promote healthy ageing.

Aging in the USA: similarities and disparities across time and space

“…Our study confirms the result of several previous studies that women, at given age, display more health deficits than men 4 , 35 , 50 , 51 , see 52 for a review and meta study, and that men develop new health deficits faster than women 2 , 3 , 22 , 53 . The feature that systems that are initially less damaged, age at faster rate is a natural outcome of the reliability theory of aging 6 .…”

The impact of interventions on management of frailty in hospitalized frail older adults: a systematic review and meta-analysis

“…Frailty is a new concept in medical sciences that is defined as "a clinically recognizable state of increased vulnerability that is the result of aging-related decline in function across multiple physiological organ systems such that the ability to cope with every day or acute stressors is compromised" [3]. There are two principal approaches to defining frailty, the frailty phenotype and the accumulation of deficits [4]. The phenotype approach of frailty uses the biological syndrome model, determining weight loss, exhaustion, weakness, low physical activity, and slowness.…”

Serum branched-chain amino acids are associated with leukocyte telomere length and frailty based on residents from Guangxi longevity county

“…As a major phenotype of aging 1 , frailty is characterized by increasing vulnerability to external factors, a decreasing the ability to resist stress, and progressive loss of muscle performance 2,3 . Further, frailty has been reported to be a dominant risk factor for major cardiovascular endpoints and mortality in elderly 2 .…”

“…Because frailty seems to be a dynamic process and also potentially reversible 3,4 , early recognition and intervention of frailty is important to achieve the goal of healthy aging. At present, the assessment of frailty is based on two methods: phenotypic method and cumulative health deficits method 1 . Compared to the phenotype approach, the accumulation of deficits approach is a more sensitive predictor for adverse health outcomes due to its finer graded scale and its multidimensionality 5 and more suitable to provide a mechanistic understanding of the aging phenomenon 6 .…”