TY - JOUR
T1 - Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults
AU - Chamberlain, Alanna M.
AU - St. Sauver, Jennifer L.
AU - Jacobson, Debra J.
AU - Manemann, Sheila M.
AU - Fan, Chun
AU - Roger, Véronique L.
AU - Yawn, Barbara P.
AU - Finney Rutten, Lila J.
N1 - Funding Information:
Funding This work was supported by the Mayo Clinic Robert D and Patricia E Kern Center for the Science of Health Care Delivery and was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG034676.
Publisher Copyright:
© 2016 BMJ Publishing Group. All rights reserved.
PY - 2016
Y1 - 2016
N2 - Objective: The goal of this study was to identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an ageing population and to determine social and behavioural factors associated with frailty trajectories. Design: Population-based cohort study. Setting: Olmsted County, Minnesota. Participants: Olmsted County, Minnesota residents aged 60-89 in 2005. Primary outcome measure: Changes in frailty over an 8-year period from 2005 to 2012, measured by constructing a yearly frailty index. Frailty trajectories by decade of age were determined using k-means cluster modelling for longitudinal data. Results: After adjustment for age and sex, all social and behavioural factors (education, marital status, living arrangements, smoking status and alcohol use) were significantly associated with frailty trajectories in those aged 60-69 and 70-79 years. After further adjustment for baseline frailty, the likelihood of being in the high frailty trajectory was greatest among those reporting concerns from relatives/friends about alcohol consumption (OR (95% CI) 2.26 (1.19 to 4.29)) and those with less than a high school education (OR (95% CI) 1.98 (1.32 to 2.96)) in the 60-69 year olds. In the 70-79 year olds, the largest associations were observed among those with concerns from oneself about alcohol consumption (OR (95% CI) 1.92 (1.23 to 3.00)), those with less than a high school education (OR (95% CI) 1.57 (1.12 to 2.22)), and those living with family (vs spouse; OR (95% CI) 1.76 (1.05 to 2.94)). No factors remained associated with frailty trajectories in the 80-89 year olds after adjustment for baseline frailty. Conclusions: Social and behavioural factors are associated with frailty, with stronger associations observed in younger ages. Recognition of social and behavioural factors associated with increasing frailty may inform interventions for individuals at risk of worsening frailty, specifically when targeted at younger individuals.
AB - Objective: The goal of this study was to identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an ageing population and to determine social and behavioural factors associated with frailty trajectories. Design: Population-based cohort study. Setting: Olmsted County, Minnesota. Participants: Olmsted County, Minnesota residents aged 60-89 in 2005. Primary outcome measure: Changes in frailty over an 8-year period from 2005 to 2012, measured by constructing a yearly frailty index. Frailty trajectories by decade of age were determined using k-means cluster modelling for longitudinal data. Results: After adjustment for age and sex, all social and behavioural factors (education, marital status, living arrangements, smoking status and alcohol use) were significantly associated with frailty trajectories in those aged 60-69 and 70-79 years. After further adjustment for baseline frailty, the likelihood of being in the high frailty trajectory was greatest among those reporting concerns from relatives/friends about alcohol consumption (OR (95% CI) 2.26 (1.19 to 4.29)) and those with less than a high school education (OR (95% CI) 1.98 (1.32 to 2.96)) in the 60-69 year olds. In the 70-79 year olds, the largest associations were observed among those with concerns from oneself about alcohol consumption (OR (95% CI) 1.92 (1.23 to 3.00)), those with less than a high school education (OR (95% CI) 1.57 (1.12 to 2.22)), and those living with family (vs spouse; OR (95% CI) 1.76 (1.05 to 2.94)). No factors remained associated with frailty trajectories in the 80-89 year olds after adjustment for baseline frailty. Conclusions: Social and behavioural factors are associated with frailty, with stronger associations observed in younger ages. Recognition of social and behavioural factors associated with increasing frailty may inform interventions for individuals at risk of worsening frailty, specifically when targeted at younger individuals.
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U2 - 10.1136/BMJOPEN-2016-011410
DO - 10.1136/BMJOPEN-2016-011410
M3 - Article
C2 - 27235302
AN - SCOPUS:85013079114
SN - 2044-6055
VL - 6
JO - BMJ Open
JF - BMJ Open
IS - 5
M1 - e011410
ER -