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Frailty in Older Men: Prevalence, Progression, and Relationship with Mortality
Author(s) -
Cawthon Peggy M.,
Marshall Lynn M.,
Michael Yvonne,
Dam ThuyTien,
Ensrud Kristine E.,
BarrettConnor Elizabeth,
Orwoll Eric S.
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01259.x
Subject(s) - medicine , hazard ratio , confidence interval , gerontology , prospective cohort study , grip strength , demography , cohort study , sarcopenia , cohort , cardiovascular health , body mass index , weakness , physical therapy , surgery , disease , sociology
OBJECTIVES: To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men. DESIGN: Cross‐sectional and prospective cohort study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand nine hundred ninety‐three community‐dwelling men aged 65 and older. MEASUREMENTS: Frailty was defined as three or more of the following: sarcopenia (low appendicular skeletal mass adjusted for height and body fat), weakness (grip strength), self‐reported exhaustion, low activity level, and slow walking speed. Prefrail men met one or two criteria; robust men had none. Follow‐up averaged 4.7 years. RESULTS: At baseline, 240 subjects (4.0%) were frail, 2,395 (40.0%) were prefrail, and 3,358 were robust (56.0%). Frail men were less healthy in most measures of self‐reported health than prefrail or robust men. Frailty was somewhat more common in African Americans (6.6%) and Asians (5.8%) than Caucasians (3.8%). At the second visit, men who were frail at baseline tended to remain frail (24.2%) or die (37.1%) or were unable to complete the follow‐up visit (26.2%); robust men tended to remain robust (54.4%). Frail men were approximately twice as likely to die as robust men (multivariate hazard ratio (MHR)=2.05, 95% confidence interval (CI)=1.55–2.72). Mortality risk for frail men was greater in all weight categories than for nonfrail men but was highest for normal‐weight frail men (MHR=2.39, 95% CI=1.51–3.79, P for interaction=.01). The relationship between frailty and mortality was somewhat stronger in younger men than older men ( P for interaction=.01). CONCLUSION: Frailty in older men is associated with poorer health and a greater risk of mortality.