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Transitional status and modifiable risk of frailty in Japanese older adults: A prospective cohort study
Author(s) -
Doi Takehiko,
Makizako Hyuma,
Tsutsumimoto Kota,
Nakakubo Sho,
Kim MinJi,
Kurita Satoshi,
Hotta Ryo,
Shimada Hiroyuki
Publication year - 2018
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.13525
Subject(s) - medicine , prospective cohort study , cohort study , gerontology , cohort , medline , political science , law
Aim The purpose of the present study was to identify risk factors for physical frailty and to understand the transitional status of frailty. Methods The participants were 4676 older adults in the National Center for Geriatrics and Gerontology ‐ Study of Geriatric Syndromes. Physical frailty status was classified as robust, pre‐frail and frail at baseline and 4‐year follow up (mean follow up 47.9 ± 1.8 months). Data for demographic variables, medical conditions, fall, depressive symptoms and cognitive function were also collected. Multiple imputation was used to reduce selection bias and loss of information. Results Progression occurred from a robust to frail status in 52 participants (2.6%) and from pre‐frailty to frailty in 281 participants (12.0%). Mortality increased with frailty status at baseline: robust 46 (2.3%), pre‐frail 112 (4.8%) and frail 54 (15.6%). In logistic regression analysis, age (OR 1.10, 95% CI 1.06–1.13), sex (men; OR 0.67, 95% CI 0.46–0.95), body mass index (OR 1.06, 95% CI 1.01–1.12]), fall (OR 1.92, 95% CI 1.31–2.81), Geriatric Depression Scale (OR 1.15, 95% CI 1.08–1.22), Mini‐Mental State Examination (OR 0.87, 95% CI 0.82–0.93) and education (OR 0.91, 95% CI 0.85–0.98), were related with new incident frailty. Among participants in the pre‐frail class at baseline, exhaustion (OR 3.24, 95% CI 1.97–5.34), physical inactivity (OR 3.09, 95% CI 1.94–4.93), lower muscle strength (OR 3.77, 95% CI 2.35–6.03) and lower mobility (OR 2.54, 95% CI 1.57–4.10) were related to progression to frailty (all P < 0.05). Conclusions The results of the present prospective study provide key information on the transitional status of frailty and the risk factors for progression to frailty. A further study is required to determine the pathophysiological changes that underlie the transition to frailty. Geriatr Gerontol Int 2018; 18: 1562–1566 .