Frailty in Older Adults: A Nationally Representative Profile in the United States

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Abstract

Background. Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people. Methods. A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained. Results. Fifteen percent (95% CI: 14%, 16%) of the older non-nursing home population is frail, and 45% is prefrail (95% CI: 44%, 47%). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42% were hospitalized in the previous year, compared to 22% of the prefrail and 11% of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year. Conclusions. Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.

Original languageEnglish (US)
Pages (from-to)1427-1434
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume70
Issue number11
DOIs
StatePublished - Nov 1 2015

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Thoracic Surgery
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Interviews
Phenotype
Population

Keywords

  • Epidemiology
  • Health disparities
  • Public health

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology

Cite this

@article{2291257c14a54f92b99bafe752a8f324,
title = "Frailty in Older Adults: A Nationally Representative Profile in the United States",
abstract = "Background. Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people. Methods. A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained. Results. Fifteen percent (95{\%} CI: 14{\%}, 16{\%}) of the older non-nursing home population is frail, and 45{\%} is prefrail (95{\%} CI: 44{\%}, 47{\%}). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42{\%} were hospitalized in the previous year, compared to 22{\%} of the prefrail and 11{\%} of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year. Conclusions. Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.",
keywords = "Epidemiology, Health disparities, Public health",
author = "{Bandeen Roche}, {Karen J} and Seplaki, {Christopher L.} and Jin Huang and Brian Buta and Kalyani, {Rita R.} and Ravi Varadhan and Xue, {Qian Li} and Walston, {Jeremy D} and Kasper, {Judith D.}",
year = "2015",
month = "11",
day = "1",
doi = "10.1093/gerona/glv133",
language = "English (US)",
volume = "70",
pages = "1427--1434",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - Frailty in Older Adults

T2 - A Nationally Representative Profile in the United States

AU - Bandeen Roche, Karen J

AU - Seplaki, Christopher L.

AU - Huang, Jin

AU - Buta, Brian

AU - Kalyani, Rita R.

AU - Varadhan, Ravi

AU - Xue, Qian Li

AU - Walston, Jeremy D

AU - Kasper, Judith D.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background. Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people. Methods. A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained. Results. Fifteen percent (95% CI: 14%, 16%) of the older non-nursing home population is frail, and 45% is prefrail (95% CI: 44%, 47%). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42% were hospitalized in the previous year, compared to 22% of the prefrail and 11% of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year. Conclusions. Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.

AB - Background. Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people. Methods. A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained. Results. Fifteen percent (95% CI: 14%, 16%) of the older non-nursing home population is frail, and 45% is prefrail (95% CI: 44%, 47%). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42% were hospitalized in the previous year, compared to 22% of the prefrail and 11% of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year. Conclusions. Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.

KW - Epidemiology

KW - Health disparities

KW - Public health

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U2 - 10.1093/gerona/glv133

DO - 10.1093/gerona/glv133

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JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

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