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Patterns and Predictors of Frailty Transitions in Older Men: The Osteoporotic Fractures in Men Study.
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- Author(s): Pollack, Lauren R.; Litwack‐Harrison, Stephanie; Cawthon, Peggy M.; Ensrud, Kristine; Lane, Nancy E.; Barrett‐Connor, Elizabeth; Dam, Thuy‐Tien
- Source:
Journal of the American Geriatrics Society; Nov2017, Vol. 65 Issue 11, p2473-2479, 7p, 1 Diagram, 3 Charts- Subject Terms:
FRAIL elderly; BONE fractures in old age; OLDER men; MEDICAL forecasting; LEAN body mass; ASTHENIA; PHYSICAL activity; WALKING speed; WOUNDS & injuries; HEALTH; COMORBIDITY; DIABETES; DIAGNOSIS; DIET therapy; EXERCISE; FATIGUE (Physiology); GAIT in humans; INTERLEUKINS; LONGITUDINAL method; OBSTRUCTIVE lung diseases; MARITAL status; MEDICAL cooperation; MEN'S health; PEOPLE with disabilities; RESEARCH; WALKING; ACTIVITIES of daily living; MULTIPLE regression analysis; SOCIAL support; INDEPENDENT living; DISEASE progression; MUSCLE weakness; DESCRIPTIVE statistics - Source:
- Additional Information
- Subject Terms:
- Abstract: Objectives To describe the natural history of frailty transitions in a large cohort of community-dwelling older men and identify predictors associated with progression to or improvement from states of greater frailty. Design Prospective cohort study. Setting Six U.S. sites. Participants Community-dwelling men aged 65 and older (N = 5,086). Measurements Frailty was measured at baseline and an average of 4.6 years later. Frailty was defined as having three or more of the following components (low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed); prefrailty was defined as having one or two components. Separate multivariable logistic regression models were analyzed for progression and improvement in frailty status. Results Of the 5,086 men, 8% were frail, 46% were prefrail, and 46% were robust at baseline. Between baseline and follow-up, 35% progressed in frailty status or died, 56% had no change in frailty status, and 15% of prefrail or frail participants improved, although only 0.5% improved across two levels, from frail to robust. In multivariable models, factors associated with improvement in frailty status included greater leg power, being married, and good or excellent self-reported health, whereas presence of any instrumental activity of daily living ( IADL) limitations, low albumin levels, high interleukin-6 levels, and presence of chronic obstructive pulmonary disease or diabetes mellitus were associated with lower likelihood of improvement in frailty status. Conclusion Improvement in frailty status was possible in this cohort of community-dwelling older men, but improvement from frail to robust was rare. Several predictors were identified as possible targets for intervention, including prevention and management of comorbid medical conditions, prevention of IADL disability, physical exercise, and nutritional and social support. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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