Frailty Phenotype and Cause-Specific Mortality in the United States
- 25 September 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences
- Vol. 75 (10), 1935-1942
- https://doi.org/10.1093/gerona/glaa025
Abstract
Frailty is a common condition among older adults increasing risk of adverse outcomes including mortality; however, little is known about the incidence or risk of specific causes of death among frail individuals. Data came from the Health and Retirement Study (2004 – 2012), linked to underlying cause-of-death information from the National Death Index (NDI). Community-dwelling HRS participants aged 65 and older who completed a general health interview and physical measurements (n=10,490) were included in analysis. Frailty was measured using phenotypic model criteria – exhaustion, low weight, low energy expenditure, slow gait, and weakness. Underlying causes of death were determined using International Classification of Diseases, Version 10 codes. We used Cox proportional hazards and competing risks regression models to calculate and compare incidence of cause-specific mortality by frailty status. During follow-up, pre-frail and frail older adults had significantly greater hazard of all-cause mortality compared to individuals without symptoms (adjusted hazard ratio (HR) pre-frail: 1.85, 95% CI: 1.51, 2.25; HR frail: 2.75, 95% CI: 2.14, 3.53). Frailty was associated with 2.96 (95% CI: 2.17, 4.03), 2.82 (95% CI: 2.02, 3.94), 3.48 (95% CI: 2.17, 5.59) and 2.87 (95% CI: 1.47, 5.59) times greater hazard of death from heart disease, cancer, respiratory illness, and dementia, respectively. Significantly greater risk of mortality from several different causes should be considered alongside the potential costs of screening and intervention for frailty in subspecialty and general geriatric clinical practice. Findings may help investigators estimate the potential impact of frailty reduction approaches on mortality.Keywords
Funding Information
- National Institute on Aging (K01AG056557, R21AG064310, U01AG0097)
This publication has 50 references indexed in Scilit:
- Association of frailty with survival: A systematic literature reviewAgeing Research Reviews, 2013
- A multifactorial interdisciplinary intervention reduces frailty in older people: randomized trialBMC Medicine, 2013
- Sarcopenia and cognitive impairment in elderly women: results from the EPIDOS cohortAge and Ageing, 2012
- Treating frailty-a practical guideBMC Medicine, 2011
- Frailty as a Predictor of Surgical Outcomes in Older PatientsJournal of the American College of Surgeons, 2010
- Prevalence and 10‐Year Outcomes of Frailty in Older Adults in Relation to Deficit AccumulationJournal of the American Geriatrics Society, 2010
- Nonlinear Multisystem Physiological Dysregulation Associated With Frailty in Older Women: Implications for Etiology and TreatmentThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2009
- Prognostic Significance of Potential Frailty CriteriaJournal of the American Geriatrics Society, 2008
- A standard procedure for creating a frailty indexBMC Geriatrics, 2008
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999