Frailty trajectories and associated factors in the years prior to death: evidence from 14 countries in the Survey of Health, Aging and Retirement in Europe

BMC Geriatrics

Research

Emiel O. Hoogendijk¹  Joshua J. Armstrong²  Lucy Stirland³  Miles Welstead³  Graciela Muniz-Terrera⁴  Natalie D. Jenkins⁵  Annie Robitaille⁶ 

[1] Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC – Location VU University Medical Center, Amsterdam, the Netherlands;Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada;Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland;Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland;Department of Neurology, Oregon Health & Science University, Portland, OR, USA;Department Social Medicine, Ohio University, Athens, USA;Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland;Glasgow Brain Injury Research Group, University of Glasgow, Glasgow, Scotland;Faculty of Health Sciences, University of Ottawa, Ottawa, Canada;

关键词: Frailty trajectories;    Longitudinal data;    Mortality;    End of life care;    Age-related changes;   

DOI  :  10.1186/s12877-023-03736-1

 received in 2022-06-24, accepted in 2023-01-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAge-related changes in frailty have been documented in the literature. However, the evidence regarding changes in frailty prior to death is scarce. Understanding patterns of frailty progression as individuals approach death could inform care and potentially lead to interventions to improve individual’s well-being at the end of life. In this paper, we estimate the progression of frailty in the years prior to death.MethodsUsing data from 8,317 deceased participants of the Survey of Health, Ageing, and Retirement in Europe, we derived a 56-item Frailty Index. In a coordinated analysis of repeated measures of the frailty index in 14 countries, we fitted growth curve models to estimate trajectories of frailty as a function of distance to death controlling both the level and rate of frailty progression for age, sex, years to death and dementia diagnosis.ResultsAcross all countries, frailty before death progressed linearly. In 12 of the 14 countries included in our analyses, women had higher levels of frailty close to the time of death, although they progressed at a slower rate than men (e.g. Switzerland (-0.008, SE = 0.003) and Spain (-0.004, SE = 0.002)). Older age at the time of death and incident dementia were associated with higher levels and increased rate of change in frailty, whilst higher education was associated with lower levels of frailty in the year preceding death (e.g. Denmark (0.000, SE = 0.001)).ConclusionThe progression of frailty before death was linear. Our results suggest that interventions aimed at slowing frailty progression may need to be different for men and women. Further longitudinal research on individual patterns and changes of frailty is warranted to support the development of personalized care pathways at the end of life.

【 授权许可】

CC BY   
© The Author(s) 2023

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