Transitions between frailty states in the very old: the influence of socioeconomic status and multi-morbidity in the Newcastle 85+ cohort study.
aged 80 and over
deprivation
frailty
multi-morbidity
older people, education
Journal
Age and ageing
ISSN: 1468-2834
Titre abrégé: Age Ageing
Pays: England
ID NLM: 0375655
Informations de publication
Date de publication:
23 10 2020
23 10 2020
Historique:
received:
04
09
2019
pubmed:
29
4
2020
medline:
29
7
2021
entrez:
29
4
2020
Statut:
ppublish
Résumé
Using Newcastle 85+ Study data, we investigated transitions between frailty states from age 85 to 90 years and whether multi-morbidities and socioeconomic status (SES) modify transitions. The Newcastle 85+ Study is a prospective, longitudinal cohort study of all people born in 1921 in Newcastle and North Tyneside. Data included: a multidimensional health assessment; general practice record review (GPRR) and date of death. Using the Fried phenotype (participants defined as robust, pre-frail or frail), frailty was measured at baseline, 18, 36 and 60 months. Frailty scores were available for 82% (696/845) of participants at baseline. The prevalence of frailty was higher in women (29.7%, 123/414) than men (17.7%, 50/282) at baseline and all subsequent time points. Of those robust at baseline, 44.6% (50/112) remained robust at 18 months and 28% (14/50) at age 90. Most (52%) remained in the same state across consecutive interviews; only 6% of the transitions were recovery (from pre-frail to robust or frail to pre-frail), and none were from frail to robust. Four or more diseases inferred a greater likelihood of progression from robust to pre-frail even after adjustment for SES. SES did not influence the likelihood of moving from one frailty state to another. Almost half the time between age 85 and 90, on average, was spent in a pre-frail state; multi-morbidity increased the chance of progression from robust and to frail; greater clinical intervention at the onset of a first chronic illness, to prevent transition to multi-morbidity, should be encouraged.
Sections du résumé
BACKGROUND
Using Newcastle 85+ Study data, we investigated transitions between frailty states from age 85 to 90 years and whether multi-morbidities and socioeconomic status (SES) modify transitions.
METHODS
The Newcastle 85+ Study is a prospective, longitudinal cohort study of all people born in 1921 in Newcastle and North Tyneside. Data included: a multidimensional health assessment; general practice record review (GPRR) and date of death. Using the Fried phenotype (participants defined as robust, pre-frail or frail), frailty was measured at baseline, 18, 36 and 60 months.
RESULTS
Frailty scores were available for 82% (696/845) of participants at baseline. The prevalence of frailty was higher in women (29.7%, 123/414) than men (17.7%, 50/282) at baseline and all subsequent time points. Of those robust at baseline, 44.6% (50/112) remained robust at 18 months and 28% (14/50) at age 90. Most (52%) remained in the same state across consecutive interviews; only 6% of the transitions were recovery (from pre-frail to robust or frail to pre-frail), and none were from frail to robust. Four or more diseases inferred a greater likelihood of progression from robust to pre-frail even after adjustment for SES. SES did not influence the likelihood of moving from one frailty state to another.
CONCLUSIONS
Almost half the time between age 85 and 90, on average, was spent in a pre-frail state; multi-morbidity increased the chance of progression from robust and to frail; greater clinical intervention at the onset of a first chronic illness, to prevent transition to multi-morbidity, should be encouraged.
Identifiants
pubmed: 32342980
pii: 5825993
doi: 10.1093/ageing/afaa054
pmc: PMC7583524
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
974-981Subventions
Organisme : Medical Research Council
ID : G0601333
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0500997
Pays : United Kingdom
Organisme : British Heart Foundation
ID : PG/08/026/24712
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/J50001X/1
Pays : United Kingdom
Organisme : Biotechnology and Biological Sciences Research Council
Pays : United Kingdom
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.
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