TY - JOUR
T1 - Frailty
T2 - Emergence and consequences in women aged 65 and older in the Women's Health Initiative observational study
AU - Woods, Nancy Fugate
AU - LaCroix, Andrea Z.
AU - Gray, Shelly L.
AU - Aragaki, Aaron
AU - Cochrane, Barbara B.
AU - Brunner, Robert L.
AU - Masaki, Kamal
AU - Murray, Anne
AU - Newman, Anne B.
PY - 2005/8
Y1 - 2005/8
N2 - OBJECTIVES: To define frailty using simple indicators; to identify risk factors for frailty as targets for prevention; and to investigate the predictive validity of this frailty classification for death, hospitalization, hip fracture, and activity of daily living (ADL) disability. DESIGN: Prospective study, the Women's Health Initiative Observational Study. SETTING: Forty U.S. clinical centers. PARTICIPANTS: Forty thousand six hundred fifty-seven women aged 65 to 79 at baseline. MEASUREMENTS: Components of frailty included self-reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss between baseline and 3 years of follow-up. Death, hip fractures, ADL disability, and hospitalizations were ascertained during an average of 5.9 years of follow-up. RESULTS: Baseline frailty was classified in 16.3% of participants, and incident frailty at 3-years was 14.8%. Older age, chronic conditions, smoking, and depressive symptom score were positively associated with incident frailty, whereas income, moderate alcohol use, living alone, and self-reported health were inversely associated. Being underweight, overweight, or obese all carried significantly higher risk of frailty than normal weight. Baseline frailty independently predicted risk of death (hazard ratio (HR) = 1.71, 95% confidence interval (CI) = 1.48-1.97), hip fracture (HR = 1.57, 95% CI = 1.11-2.20), ADL disability (odds ratio (OR) = 3.15, 95% CI = 2.47-4.02), and hospitalizations (OR = 1.95, 95% CI = 1.72-2.22) after adjustment for demographic characteristics, health behaviors, disability, and comorbid conditions. CONCLUSION: These results support the robustness of the concept of frailty as a geriatric syndrome that predicts several poor outcomes in older women. Underweight, obesity, smoking, and depressive symptoms are strongly associated with the development of frailty and represent important targets for prevention.
AB - OBJECTIVES: To define frailty using simple indicators; to identify risk factors for frailty as targets for prevention; and to investigate the predictive validity of this frailty classification for death, hospitalization, hip fracture, and activity of daily living (ADL) disability. DESIGN: Prospective study, the Women's Health Initiative Observational Study. SETTING: Forty U.S. clinical centers. PARTICIPANTS: Forty thousand six hundred fifty-seven women aged 65 to 79 at baseline. MEASUREMENTS: Components of frailty included self-reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss between baseline and 3 years of follow-up. Death, hip fractures, ADL disability, and hospitalizations were ascertained during an average of 5.9 years of follow-up. RESULTS: Baseline frailty was classified in 16.3% of participants, and incident frailty at 3-years was 14.8%. Older age, chronic conditions, smoking, and depressive symptom score were positively associated with incident frailty, whereas income, moderate alcohol use, living alone, and self-reported health were inversely associated. Being underweight, overweight, or obese all carried significantly higher risk of frailty than normal weight. Baseline frailty independently predicted risk of death (hazard ratio (HR) = 1.71, 95% confidence interval (CI) = 1.48-1.97), hip fracture (HR = 1.57, 95% CI = 1.11-2.20), ADL disability (odds ratio (OR) = 3.15, 95% CI = 2.47-4.02), and hospitalizations (OR = 1.95, 95% CI = 1.72-2.22) after adjustment for demographic characteristics, health behaviors, disability, and comorbid conditions. CONCLUSION: These results support the robustness of the concept of frailty as a geriatric syndrome that predicts several poor outcomes in older women. Underweight, obesity, smoking, and depressive symptoms are strongly associated with the development of frailty and represent important targets for prevention.
KW - Activities of daily living
KW - Disability
KW - Ethnicity
KW - Frailty
KW - Postmenopausal women
KW - Women's Health Initiative
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UR - http://www.scopus.com/inward/citedby.url?scp=25144445282&partnerID=8YFLogxK
U2 - 10.1111/j.1532-5415.2005.53405.x
DO - 10.1111/j.1532-5415.2005.53405.x
M3 - Article
C2 - 16078957
AN - SCOPUS:25144445282
SN - 0002-8614
VL - 53
SP - 1321
EP - 1330
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 8
ER -
