Frailty and Mortality Outcomes in Cognitively Normal Older People

Sex Differences in a Population-Based Study

Mairead M. Bartley, Yonas Endale Geda, Teresa J H Christianson, V. Shane Pankratz, Rosebud O Roberts, Ronald Carl Petersen

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality. Design Population-based prospective cohort study: Mayo Clinic Study of Aging. Setting Olmsted County, Minnesota. Participants Cognitively normal older persons aged 70 and older (mean age 78.8 ± 5.2, 50.2% male; N = 2,356). Measurements Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models. Results The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR) = 3.91, 95% confidence interval (CI) = 2.69-5.68). The association was stronger in women (HR = 5.26, 95% CI = 2.88-9.61) than men (HR = 3.15, 95% CI = 1.98-5.02). Conclusion Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.

Original languageEnglish (US)
Pages (from-to)132-137
Number of pages6
JournalJournal of the American Geriatrics Society
Volume64
Issue number1
DOIs
StatePublished - Jan 1 2016

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Sex Characteristics
Mortality
Confidence Intervals
Population
Proportional Hazards Models
Geriatrics
Cohort Studies
Prospective Studies

Keywords

  • aging
  • frailty
  • Frailty Index
  • mortality
  • sex differences

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Frailty and Mortality Outcomes in Cognitively Normal Older People : Sex Differences in a Population-Based Study. / Bartley, Mairead M.; Geda, Yonas Endale; Christianson, Teresa J H; Shane Pankratz, V.; Roberts, Rosebud O; Petersen, Ronald Carl.

In: Journal of the American Geriatrics Society, Vol. 64, No. 1, 01.01.2016, p. 132-137.

Research output: Contribution to journalArticle

Bartley, Mairead M. ; Geda, Yonas Endale ; Christianson, Teresa J H ; Shane Pankratz, V. ; Roberts, Rosebud O ; Petersen, Ronald Carl. / Frailty and Mortality Outcomes in Cognitively Normal Older People : Sex Differences in a Population-Based Study. In: Journal of the American Geriatrics Society. 2016 ; Vol. 64, No. 1. pp. 132-137.
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abstract = "Objectives To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality. Design Population-based prospective cohort study: Mayo Clinic Study of Aging. Setting Olmsted County, Minnesota. Participants Cognitively normal older persons aged 70 and older (mean age 78.8 ± 5.2, 50.2{\%} male; N = 2,356). Measurements Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models. Results The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR) = 3.91, 95{\%} confidence interval (CI) = 2.69-5.68). The association was stronger in women (HR = 5.26, 95{\%} CI = 2.88-9.61) than men (HR = 3.15, 95{\%} CI = 1.98-5.02). Conclusion Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.",
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N2 - Objectives To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality. Design Population-based prospective cohort study: Mayo Clinic Study of Aging. Setting Olmsted County, Minnesota. Participants Cognitively normal older persons aged 70 and older (mean age 78.8 ± 5.2, 50.2% male; N = 2,356). Measurements Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models. Results The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR) = 3.91, 95% confidence interval (CI) = 2.69-5.68). The association was stronger in women (HR = 5.26, 95% CI = 2.88-9.61) than men (HR = 3.15, 95% CI = 1.98-5.02). Conclusion Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.

AB - Objectives To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality. Design Population-based prospective cohort study: Mayo Clinic Study of Aging. Setting Olmsted County, Minnesota. Participants Cognitively normal older persons aged 70 and older (mean age 78.8 ± 5.2, 50.2% male; N = 2,356). Measurements Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models. Results The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR) = 3.91, 95% confidence interval (CI) = 2.69-5.68). The association was stronger in women (HR = 5.26, 95% CI = 2.88-9.61) than men (HR = 3.15, 95% CI = 1.98-5.02). Conclusion Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.

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