1. Natural course of frailty components in people who develop frailty syndrome
- Author
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Jussi Vahtera, Jack M. Guralnik, Luigi Ferrucci, Sari Stenholm, Martijn Huisman, Mika Kivimäki, Jaana Pentti, Emiel O. Hoogendijk, Joni V Lindbohm, Stefania Bandinelli, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki University Hospital Area, HUS Neurocenter, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, APH - Quality of Care, Sociology [until 2010], Sociology, and The Social Context of Aging (SoCA)
- Subjects
Male ,Gerontology ,Aging ,Exhaustion ,PREDICTION ,Walking speed ,PHENOTYPE ,FATIGUE ,0302 clinical medicine ,Weight loss ,Longitudinal Studies ,030212 general & internal medicine ,Aged, 80 and over ,Frailty ,ta3142 ,Syndrome ,The Journal of Gerontology: Medical Sciences ,Disease Progression ,Female ,medicine.symptom ,Cohort study ,Weakness ,Frail Elderly ,Frailty syndrome ,TRANSITIONS ,03 medical and health sciences ,FRACTURES ,SDG 3 - Good Health and Well-being ,medicine ,Humans ,OLDER-ADULTS ,Geriatric Assessment ,Aged ,Natural course ,business.industry ,Physical activity ,Muscle strength ,DISABILITY ,MORTALITY ,WOMENS HEALTH ,medicine.disease ,Confidence interval ,Preferred walking speed ,POISSON REGRESSION APPROACH ,Relative risk ,3121 General medicine, internal medicine and other clinical medicine ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Frailty is an important geriatric syndrome, but little is known about its development in the years preceding onset of the syndrome. The aim of this study was to examine the progression of frailty and compare the trajectories of each frailty component prior to frailty onset.METHODS: Repeat data were from two cohort studies: the Longitudinal Aging Study Amsterdam (n = 1440) with a 15-year follow-up and the InCHIANTI Study (n = 998) with a 9-year follow-up. Participants were classified as frail if they had >3 frailty components (exhaustion, slowness, physical inactivity, weakness, and weight loss). Transitions between frailty components were examined with multistate modeling. Trajectories of frailty components were compared among persons who subsequently developed frailty to matched nonfrail persons by using mixed effects models.RESULTS: The probabilities were 0.43, 0.40, and 0.36 for transitioning from 0 to 1 frailty component, from 1 component to 2 components, and from 2 components to 3-5 components (the frail state). The transition probability from frail to death was 0.13. Exhaustion separated frail and nonfrail groups already 9 years prior to onset of frailty (pooled risk ratio [RR] = 1.53, 95% confidence interval [CI] 1.04-2.24). Slowness (RR = 1.94, 95% CI 1.44-2.61), low activity (RR = 1.59, 95% CI 1.19-2.13), and weakness (RR = 1.39, 95% CI 1.10-1.76) separated frail and nonfrail groups 6 years prior to onset of frailty. The fifth frailty component, weight loss, separated frail and nonfrail groups only at the onset of frailty (RR = 3.36, 95% CI 2.76-4.08).CONCLUSIONS: Evidence from two cohort studies suggests that feelings of exhaustion tend to emerge early and weight loss near the onset of frailty syndrome.
- Published
- 2019