Social vulnerability and survival across levels of frailty in the Honolulu-Asia Aging Study

Joshua J. Armstrong, Melissa K. Andrew, Arnold Mitnitski, Lenore J. Launer, Lon R. White, Kenneth Rockwood

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

79 Citas (Scopus)

Resumen

Purpose: we evaluated mortality risk in relation to social vulnerability across levels of frailty among a cohort of older Japanese-American men. Methods: in secondary analysis of the Honolulu-Asia Aging Study (HAAS), participants (n = 3,271) were aged 72-93 years at baseline. A frailty index (FI) created using 58 potential health deficits to quantify participants' frailty level at baseline, with four frailty strata: 0.0 < FI ≤ 0.1 (n = 1,074); 0.1 < FI ≤ 0.20 (n = 1,549); 0.2 < FI ≤ 0.30 (n = 472); FI > 0.3 (n = 176). Similarly, a social vulnerability index was created using 19 self-reported social deficits. Cox proportional hazard modelling was employed to estimate the impact of social vulnerability across the four levels of frailty, accounting for age, smoking, alcohol use and variation in health deficits within each frailty level. Results: for the fittest participants, social vulnerability was associated with mortality (hazards ratio (HR) = 1.04, 95% confidence interval (CI) = 1.01, 1.07; P value = 0.008). Similarly, for those considered at risk for frailty, each social deficit was associated with a 5% increased risk of mortality. For frail individuals, the Cox regression analyses indicated that social vulnerability was not significantly associated with mortality (0.2 < FI ≤ 0.3: HR = 1.016, 95% CI = 0.98, 1.06; P value = 0.442; FI > 0.3: HR = 0.98, 95% CI = 0.93, 1.04). Conclusions: for the fittest and at-risk HAAS participants, the accumulation of social deficits was associated with significant increases in mortality risk. For frail individuals (FI > 0.20), the estimation of mortality risk may depend more so on intrinsic factors related to their health.

Idioma originalEnglish
Páginas (desde-hasta)709-712
Número de páginas4
PublicaciónAge and Ageing
Volumen44
N.º4
DOI
EstadoPublished - jul. 1 2015

Nota bibliográfica

Publisher Copyright:
© The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

ASJC Scopus Subject Areas

  • Ageing
  • Geriatrics and Gerontology

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