The dynamics of frailty development and progression in older adults in primary care in England (2006–2017): a retrospective cohort profile

BMC Geriatrics

The Frailty Dynamics study team¹  Andrew Clegg²  Harnish P. Patel³  Simon de Lusignan⁴  Tracey England⁵  Francesca Lambert⁵  Vivienne Windle⁵  Bronagh Walsh⁵  Carole Fogg⁵  Dave Evenden⁵  Shihua Zhu⁶  Simon D. S. Fraser⁶  Paul Roderick⁶  Scott Harris⁶  Sally Brailsford⁷  Abigail Barkham⁸ 

[1] ;Academic Unit for Ageing & Stroke Research, University of Leeds, Bradford Teaching Hospitals NHS Foundation Trust;Medicine for Older People, University Hospitals Southampton NHS Foundation Trust, Southampton General Hospital;Nuffield Department of Primary Care Health Sciences, University of Oxford;School of Heath Sciences, Faculty of Environmental and Life Sciences, University of Southampton;School of Primary Care, Population Sciences, and Medical Education, Faculty of Medicine, Southampton General Hospital;Southampton Business School, University of Southampton;Southern Health NHS Foundation Trust;

关键词: Frailty;    Cohort study;    Adults;    Trajectories;    Computer simulation modelling;    Primary care;   

DOI  :  10.1186/s12877-021-02684-y

来源: DOAJ

【 摘 要 】

Abstract Background Frailty is a common condition in older adults and has a major impact on patient outcomes and service use. Information on the prevalence in middle-aged adults and the patterns of progression of frailty at an individual and population level is scarce. To address this, a cohort was defined from a large primary care database in England to describe the epidemiology of frailty and understand the dynamics of frailty within individuals and across the population. This article describes the structure of the dataset, cohort characteristics and planned analyses. Methods Retrospective cohort study using electronic health records. Participants were aged ≥50 years registered in practices contributing to the Oxford Royal College of General Practitioners Research and Surveillance Centre between 2006 to 2017. Data include GP practice details, patient sociodemographic and clinical characteristics, twice-yearly electronic Frailty Index (eFI), deaths, medication use and primary and secondary care health service use. Participants in each cohort year by age group, GP and patient characteristics at cohort entry are described. Results The cohort includes 2,177,656 patients, contributing 15,552,946 person-years, registered at 419 primary care practices in England. The mean age was 61 years, 52.1% of the cohort was female, and 77.6% lived in urban environments. Frailty increased with age, affecting 10% of adults aged 50–64 and 43.7% of adults aged ≥65. The prevalence of long-term conditions and specific frailty deficits increased with age, as did the eFI and the severity of frailty categories. Conclusion A comprehensive understanding of frailty dynamics will inform predictions of current and future care needs to facilitate timely planning of appropriate interventions, service configurations and workforce requirements. Analysis of this large, nationally representative cohort including participants aged ≥50 will capture earlier transitions to frailty and enable a detailed understanding of progression and impact. These results will inform novel simulation models which predict future health and service needs of older people living with frailty. Study registration Registered on www.clinicaltrials.gov October 25th 2019, NCT04139278 .

【 授权许可】

Unknown