Journal ArticleDOI
Frailty in Older Adults Evidence for a Phenotype
Linda P. Fried,Catherine M. Tangen,Jeremy D. Walston,Anne B. Newman,Calvin H. Hirsch,John S. Gottdiener,Teresa E. Seeman,Russell P. Tracy,Willem J. Kop,B Gregory Burke,Mary Ann McBurnie +10 more
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TLDR
This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition, and finds that there is an intermediate stage identifying those at high risk of frailty.Abstract:
Background: Frailty is considered highly prevalent in old age and to confer high risk for falls, disability, hospitalization, and mortality. Frailty has been considered synonymous with disability, comorbidity, and other characteristics, but it is recognized that it may have a biologic basis and be a distinct clinical syndrome. A standardized definition has not yet been established.
Methods: To develop and operationalize a phenotype of frailty in older adults and assess concurrent and predictive validity, the study used data from the Cardiovascular Health Study. Participants were 5,317 men and women 65 years and older (4,735 from an original cohort recruited in 1989-90 and 582 from an African American cohort recruited in 1992-93). Both cohorts received almost identical baseline evaluations and 7 and 4 years of follow-up, respectively, with annual examinations and surveillance for outcomes including incident disease, hospitalization, falls, disability, and mortality.
Results: Frailty was defined as a clinical syndrome in which three or more of the following criteria were present: unintentional weight loss (10 lbs in past year), self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity. The overall prevalence of frailty in this community-dwelling population was 6.9%; it increased with age and was greater in women than men. Four-year incidence was 7.2%. Frailty was associated with being African American, having lower education and income, poorer health, and having higher rates of comorbid chronic diseases and disability. There was overlap, but not concordance, in the cooccurrence of frailty, comorbidity, and disability. This frailty phenotype was independently predictive (over 3 years) of incident falls, worsening mobility or ADL disability, hospitalization, and death, with hazard ratios ranging from 1.82 to 4.46, unadjusted, and 1.29-2.24, adjusted for a number of health, disease, and social characteristics predictive of 5-year mortality. Intermediate frailty status, as indicated by the presence of one or two criteria, showed intermediate risk of these outcomes as well as increased risk of becoming frail over 3-4 years of follow-up (odds ratios for incident frailty = 4.51 unadjusted and 2.63 adjusted for covariates, compared to those with no frailty criteria at baseline).
Conclusions: This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition. It also finds that there is an intermediate stage identifying those at high risk of frailty. Finally, it provides evidence that frailty is not synonymous with either comorbidity or disability, but comorbidity is an etiologic risk factor for, and disability is an outcome of, frailty. This provides a potential basis for clinical assessment for those who are frail or at risk, and for future research to develop interventions for frailty based on a standardized ascertainment of frailty.read more
Citations
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Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools
Simone Perna,Matthew Francis,Chiara Bologna,F. Moncaglieri,Antonella Riva,Paolo Morazzoni,Pietro Allegrini,A. Isu,Beatrice Vigo,Fabio Guerriero,Mariangela Rondanelli +10 more
TL;DR: This study suggests that measuring frailty with EFS is helpful and performance tool for stratifying the state of fragility in a group of institutionalized elderly.
Journal ArticleDOI
Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease.
TL;DR: Frailty is an important predictor of postoperative outcomes following degenerative spine surgery and preoperative recognition of frailty may be useful for perioperative optimization, risk stratification, and patient counseling.
Journal ArticleDOI
Clinically Relevant Frailty Index for Mice
TL;DR: The development of a Frailty Index in 27- to 28-month-old C57BL/6 mice that matched the clinical criteria used in humans that provided a potential standardized definition for frailty in mice that is consistent with the operational definition ofFrailty in humans.
Journal ArticleDOI
A new operational definition of frailty: the Frailty Trait Scale.
Francisco José García-García,Laure Carcaillon,Jesús Ángel Fernández-Tresguerres,Ana Alfaro,Jose L. Larrion,Carmen Castillo,Leocadio Rodríguez-Mañas +6 more
TL;DR: The Frailty Trait Scale associates with many of the factors linked to frailty and has a similar predictive capacity to that provided by the classical instruments, with potential utility in research and clinical practice.
Journal ArticleDOI
Antidepressant Use, Depressive Symptoms, and Incident Frailty in Women Aged 65 and Older from the Women’s Health Initiative Observational Study
Susan L. Lakey,Andrea Z. LaCroix,Shelly L. Gray,Soo Borson,Carla Williams,Darren Calhoun,Joseph S. Goveas,Jordan W. Smoller,Judith K. Ockene,Kamal Masaki,Mathilda Coday,Milagros C. Rosal,Nancy Fugate Woods +12 more
TL;DR: To examine the associations between depressive symptoms, antidepressant use, and duration of use with incident frailty 3 years later in nonfrail women aged 65 and older, the aim was to establish a baseline level of baseline depression and establish an apples-to- apples relationship.
References
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