期刊
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
卷 76, 期 9, 页码 1627-1632出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/gerona/glaa266
关键词
Epidemiology; Frailty; Mortality; Public health
资金
- National Institute on Aging [NIA U01AG009740]
- European Commission [QLK6-CT-2001-00360, SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812, 211909, 227822, 261982, 676536, 654221]
- DG Employment, Social Affairs Inclusion
- German Ministry of Education and Research
- Max Planck Society for the Advancement of Science
- U.S. National Institute on Aging [U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_ AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_ 04-064, HHSN271201300071C]
- National Institute of Aging [R01AG017644]
- consortium of UK government
- Ministry of Health Welfare and Sports, Directorate of Long-Term Care
Various studies have shown consistent associations between current FI levels, baseline FI levels, and mortality. Additionally, individuals with steeper FI growth have a higher risk of mortality.
Background: Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality. Methods: In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data. Results: Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95% credible interval [CI] = 1.03-1.05) and baseline FI levels (HR = 1.03, 95% CI = 1.03-1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95% CI = 1.49-1.63) in HRS, HR = 1.24 (95% CI = 1.13-1.35) in SHARE, HR = 1.40 (95% CI = 1.25-1.52) in ELSA, and HR = 1.71 (95% CI = 1.46-2.01) in LASA. Conclusions: FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual's frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.
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