Abstract
Background: age-specific mortality reduction has been accompanied by a decrease in the prevalence of some diseases and an increase in others. Whether populations are becoming 'healthier' depends on which aspect of health is being considered. Frailty has been proposed as an integrative measure to quantify health status. Objective: to investigate changes in the near-term lethality of frailty before and after a 20-year interval using the frailty index (FI), a summary of age-related health deficit accumulation. Design: baseline data from the Cognitive Function and Ageing Studies (CFAS) in 1991 (n = 7,635) and 2011 (n = 7,762). Setting: three geographically distinct UK centres (Newcastle, Cambridgeshire and Nottingham). Subjects: individuals aged 65 and over (both institutionalised and community-living). Methods: a 30-item frailty score was used, which includes morbidities, risk factors and subjective measures of disability. Missing items were imputed using multiple imputations by chained equations. Binomial regression was used to investigate the relationship between frailty, age, sex and cohort. Two-year mortality was modelled using logistic regression. Results: mean frailty was slightly higher in CFAS II (0.19, 95% confidence interval (CI): 0.19-0.20) than CFAS I (0.18, 95% CI: 0.17-0.18). Two-year mortality in CFAS I was higher than in CFAS II (odds ratio (OR) = 1.16, 95% CI: 1.03-1.30). The association between frailty and 2-year mortality was non-linear with an OR of ∼1.6 for each 0.10 increment in the FI. Conclusions: the relationship between frailty and mortality did not significantly differ across the studies. Severe frailty as an indicator of mortality is shown to be a stable construct.
| Original language | English |
|---|---|
| Pages (from-to) | 721-727 |
| Number of pages | 7 |
| Journal | Age and Ageing |
| Volume | 47 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Sept 1 2018 |
Bibliographical note
Funding Information:This work was supported by the UK Medical Research Council, who part funded the original CFAS study, and the CFAS II baseline and follow-up wave. Fiona Matthews is part funded by UK Medical Research Council MC_UU_00002/12. This work was also supported by the Alzheimer’s Society (project grant number 294). They had no role in the analysis, study design or decision to publish.
Funding Information:
K.R. is the President and the Chief Science Officer of DGI Clinical, which has contracts with pharma on individualised outcome measurement. In 2017, he attended an advisory board meeting with Lundbeck. Otherwise, all personal fees are for invited guest lectures and academic symposia. He is the Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, with additional funding from the Alzheimer Society of Canada and several other charities, as well as from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Nova Scotia Health Research Foundation, the Capital Health Research Fund and the Fountain Family Innovation Fund of the Nova Scotia Health Authority Foundation
Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society.
ASJC Scopus Subject Areas
- Ageing
- Geriatrics and Gerontology