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

Sari Stenholm, Luigi Ferrucci, Jussi Vahtera, Emiel O. Hoogendijk, Martijn Huisman, Jaana Pentti, Joni V. Lindbohm, Stefania Bandinelli, Jack M. Guralnik, Mika Kivimäki

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)667-674
JournalThe journals of gerontology. Series A, Biological sciences and medical sciences
Volume74
Issue number5
Early online date1 Aug 2018
DOIs
Publication statusPublished - 2019

Cite this

Stenholm, Sari ; Ferrucci, Luigi ; Vahtera, Jussi ; Hoogendijk, Emiel O. ; Huisman, Martijn ; Pentti, Jaana ; Lindbohm, Joni V. ; Bandinelli, Stefania ; Guralnik, Jack M. ; Kivimäki, Mika. / Natural Course of Frailty Components in People Who Develop Frailty Syndrome : Evidence From Two Cohort Studies. In: The journals of gerontology. Series A, Biological sciences and medical sciences. 2019 ; Vol. 74, No. 5. pp. 667-674.
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title = "Natural Course of Frailty Components in People Who Develop Frailty Syndrome: Evidence From Two Cohort Studies",
abstract = "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.",
author = "Sari Stenholm and Luigi Ferrucci and Jussi Vahtera and Hoogendijk, {Emiel O.} and Martijn Huisman and Jaana Pentti and Lindbohm, {Joni V.} and Stefania Bandinelli and Guralnik, {Jack M.} and Mika Kivim{\"a}ki",
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Natural Course of Frailty Components in People Who Develop Frailty Syndrome : Evidence From Two Cohort Studies. / Stenholm, Sari; Ferrucci, Luigi; Vahtera, Jussi; Hoogendijk, Emiel O.; Huisman, Martijn; Pentti, Jaana; Lindbohm, Joni V.; Bandinelli, Stefania; Guralnik, Jack M.; Kivimäki, Mika.

In: The journals of gerontology. Series A, Biological sciences and medical sciences, Vol. 74, No. 5, 2019, p. 667-674.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Natural Course of Frailty Components in People Who Develop Frailty Syndrome

T2 - Evidence From Two Cohort Studies

AU - Stenholm, Sari

AU - Ferrucci, Luigi

AU - Vahtera, Jussi

AU - Hoogendijk, Emiel O.

AU - Huisman, Martijn

AU - Pentti, Jaana

AU - Lindbohm, Joni V.

AU - Bandinelli, Stefania

AU - Guralnik, Jack M.

AU - Kivimäki, Mika

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

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