TY - JOUR
T1 - Patterns and Predictors of Frailty Transitions in Older Men
T2 - The Osteoporotic Fractures in Men Study
AU - Pollack, Lauren R.
AU - Litwack-Harrison, Stephanie
AU - Cawthon, Peggy M.
AU - Ensrud, Kristine
AU - Lane, Nancy E.
AU - Barrett-Connor, Elizabeth
AU - Dam, Thuy Tien
N1 - Publisher Copyright:
© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society
PY - 2017/11
Y1 - 2017/11
N2 - 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.
AB - 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.
KW - frailty
KW - older adults
KW - predictors
KW - transitions
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U2 - 10.1111/jgs.15003
DO - 10.1111/jgs.15003
M3 - Article
C2 - 28873220
AN - SCOPUS:85028872552
SN - 0002-8614
VL - 65
SP - 2473
EP - 2479
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 11
ER -