Abstract
Objectives
To examine the relationship between frailty status and risk of all-cause and cause-specific
mortality.
Design
Longitudinal cohort study with an 11-year follow up.
Setting and participants
Data from the Survey on Health, Aging and Retirement in Europe (SHARE) were used.
In the analysis, we included data from 11 European countries. We included men and
women older than 50 years residing in Europe. Overall, 24,634 participants were analyzed
with a mean age of 64.2 (9.8), 53.6% female, where 14.7% and 6.9% were found to be
prefrail or frail, respectively, at the baseline.
Methods
Frailty status was calculated using the SHARE–Frailty Instrument, categorizing the
participants as robust, prefrail, and frail. Multivariate Cox regression models were
used to estimate the risk of all-cause and cause-specific (stroke, heart attack, other
cardiovascular disease, cancer, respiratory illness, infectious, and digestive and
other) mortality.
Results
During the follow-up, and after adjusting for sex, age, education, body mass index,
smoking, alcohol consumption, and number of comorbidities, frailty was associated
with a higher risk of all-cause (HR 2.17, 95% CI 1.90-2.48) and mortality due to stroke
(HR 2.06, 95% CI 1.37-3.10), heart attack (HR 1.67, 95% CI 1.19-2.34), other cardiovascular
disease (HR 2.77, 95% CI 1.87-4.12), cancer (HR 2.11, 95% CI 1.63-2.73), respiratory
disease (HR 2.76, 95% CI 1.66-4.60), infectious diseases (HR 1.79, 95% CI 1.03-3.11),
and digestive and other causes (HR 2.02, 95% CI 1.51-2.71). Prefrailty was associated
with a higher risk of all-cause (HR 1.47, 95% CI 1.31-1.63), heart attack (HR 1.31,
95% CI 1.01-1.72), other cardiovascular disease (HR 2.03, 95% CI 1.46-2.81), respiratory
disease (HR 1.70, 95% CI 1.09-2.65), and digestive and other causes (HR 1.50, 95%
CI 1.18-1.91) mortality.
Conclusions and implications
Baseline prefrailty and frailty are associated with increased all-cause and cause-specific
mortality over an 11-year follow up. Public health policy should include preventive
programs aimed at older adults to prevent frailty and reduce mortality.
Keywords
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Article info
Publication history
Published online: July 24, 2019
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
