Longitudinal changes of frailty in 8 years: comparisons between physical frailty and frailty index

BMC Geriatrics

Liang-Yu Chen¹  Ming-Hsien Lin¹  Li-Ning Peng¹  Liang-Kung Chen²  An-Chun Hwang³  Wei-Ju Lee⁴  Nicole Huang⁵  Yiing-Jenq Chou⁶ 

[1] Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan;Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan;Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan;Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan;Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Institute of Public Health, National Yang Ming Chiao Tung University, No.115, Sec. 2, Li-Nong Street, 112, Taipei, Taiwan;Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan County, Taiwan;Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan;Institute of Public Health, National Yang Ming Chiao Tung University, No.115, Sec. 2, Li-Nong Street, 112, Taipei, Taiwan;Office of the Deputy Superintendent, National Yang Ming Chiao Tung University Hospital, Yilan County, Taiwan;

关键词: Frailty phenotype;    Frailty index;    Trajectory;    Associated factors;    Disability;   

DOI  :  10.1186/s12877-021-02665-1

来源: Springer

【 摘 要 】

BackgroundFew studies have made longitudinal comparisons between frailty phenotype (FP) and frailty index (FI) changes. We aimed to investigate frailty status changes defined by FP and FI concurrently, and to compare the associated factors and incident disability among different combination of FI and FP trajectory groups.MethodsData on respondents aged over 50 who completed the 1999, 2003 and 2007 Taiwan Longitudinal Study on Aging (TLSA) surveys (n = 2807) were excerpted. Changes of FI, FP and major time-dependent variables were constructed by group-based trajectory modeling. Logistic regression was used to investigate the associated factors and relationships with incident disability among different frailty trajectories.ResultsWe identified four FP trajectories – stably robust, worsened frailty, improved frailty, and stably frail and three FI trajectories – stable FI, moderate increase FI and rapid increase FI. Lower self-rated health, mobility impairment, and depressed mood were associated with unfavorable FP and FI changes (all p < 0.001). Regardless of FP trajectory groups, the moderate and rapid increase FI group had significantly more comorbidities than the stable FI group, and more visual, hearing, oral intake impairment, more difficulty in meeting living expenses, and poorer cognitive function in ≥65-year-olds (all p < 0.05). In addition, the worsened frailty, improved frailty, and stably frail groups had ORs for incident disability of 10.5, 3.0, and 13.4, respectively, compared with the stably robust group (all p < 0.01); the moderate and rapid increase FI groups had 8.4-fold and 77.5-fold higher risk than the stable FI group (both p < 0.001). When combining FI and FP trajectories, risk increased with FI trajectory steepness, independent of FP change (all p < 0.01 in rapid increase FI vs stable FI).ConclusionsFour FP trajectories (stably robust, worsened frailty, improved frailty, and stably frail) and three FI trajectories (stable FI, moderate increase FI and rapid increase FI) were identified. Lower self-rated health, mobility impairment, and depressed mood were associated with both unfavorable FP and FI trajectories. Nevertheless, even for individuals in stably robust or improved frailty FP groups, moderate or rapid increase in FI, either due to comorbidities, sensory impairment, cognitive deficits, or financial challenges, may still increase the risk of incident disability.

【 授权许可】

CC BY