Natural Course of Frailty Components in People Who Develop Frailty Syndrome: Evidence From Two Cohort Studies.

Autor:	Stenholm S; Department of Public Health, University of Turku and Turku University Hospital, Finland., Ferrucci L; Intramural Research Program, National Institute on Aging, Baltimore, Maryland., Vahtera J; Department of Public Health, University of Turku and Turku University Hospital, Finland., Hoogendijk EO; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, The Netherlands., Huisman M; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, The Netherlands.; Department of Sociology, VU University, Amsterdam, The Netherlands., Pentti J; Department of Public Health, University of Turku and Turku University Hospital, Finland.; Clinicum, Faculty of Medicine, University of Helsinki, Finland., Lindbohm JV; Clinicum, Faculty of Medicine, University of Helsinki, Finland., Bandinelli S; Geriatric Unit, Azienda Sanitaria di Firenze, Florence, Italy., Guralnik JM; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore., Kivimäki M; Clinicum, Faculty of Medicine, University of Helsinki, Finland.; Department of Epidemiology and Public Health, University College London Medical School, UK.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2019 Apr 23; Vol. 74 (5), pp. 667-674.
DOI:	10.1093/gerona/gly132
Abstrakt:	Background: Frailty is an important geriatric syndrome, but little is known about its development in the years preceding onset of the syndrome. The aim of this study was to examine the progression of frailty and compare the trajectories of each frailty component prior to frailty onset. Methods: Repeat data were from two cohort studies: the Longitudinal Aging Study Amsterdam (n = 1440) with a 15-year follow-up and the InCHIANTI Study (n = 998) with a 9-year follow-up. Participants were classified as frail if they had >3 frailty components (exhaustion, slowness, physical inactivity, weakness, and weight loss). Transitions between frailty components were examined with multistate modeling. Trajectories of frailty components were compared among persons who subsequently developed frailty to matched nonfrail persons by using mixed effects models. Results: The probabilities were 0.43, 0.40, and 0.36 for transitioning from 0 to 1 frailty component, from 1 component to 2 components, and from 2 components to 3-5 components (the frail state). The transition probability from frail to death was 0.13. Exhaustion separated frail and nonfrail groups already 9 years prior to onset of frailty (pooled risk ratio [RR] = 1.53, 95% confidence interval [CI] 1.04-2.24). Slowness (RR = 1.94, 95% CI 1.44-2.61), low activity (RR = 1.59, 95% CI 1.19-2.13), and weakness (RR = 1.39, 95% CI 1.10-1.76) separated frail and nonfrail groups 6 years prior to onset of frailty. The fifth frailty component, weight loss, separated frail and nonfrail groups only at the onset of frailty (RR = 3.36, 95% CI 2.76-4.08). Conclusions: Evidence from two cohort studies suggests that feelings of exhaustion tend to emerge early and weight loss near the onset of frailty syndrome. (© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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