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Progression of frailty and prevalence of osteoporosis in a community cohort of older women—a 10-year longitudinal study

Bartosch, P. LU ; McGuigan, F. E. LU and Akesson, K. E. LU (2018) In Osteoporosis International 29(10). p.2191-2199
Abstract

Summary: In community dwelling, 75-year-old women followed 10 years, a frailty index was created at each of three visits. Frailty score increased by ~ 6–7% annually. A higher frailty score was equivalent to being 5–10 years chronologically older. Frailty was associated with low bone density and higher risk of dying. Introduction: To understand the distribution of frailty among a population-based sample of older community-dwelling women, progression over 10 years, and association with mortality and osteoporosis. Methods: The study is performed in a cohort designed to investigate osteoporosis. The OPRA cohort consists of 75-year-old women, n = 1044 at baseline, and follow-up at age 80 and 85. A frailty index (scored from 0.0–1.0) based on... (More)

Summary: In community dwelling, 75-year-old women followed 10 years, a frailty index was created at each of three visits. Frailty score increased by ~ 6–7% annually. A higher frailty score was equivalent to being 5–10 years chronologically older. Frailty was associated with low bone density and higher risk of dying. Introduction: To understand the distribution of frailty among a population-based sample of older community-dwelling women, progression over 10 years, and association with mortality and osteoporosis. Methods: The study is performed in a cohort designed to investigate osteoporosis. The OPRA cohort consists of 75-year-old women, n = 1044 at baseline, and follow-up at age 80 and 85. A frailty index (scored from 0.0–1.0) based on deficits in health across multiple domains was created at all time-points; outcomes were mortality up to 15 years and femoral neck bone density. Results: At baseline, the proportion least frail, i.e., most robust (FI 0.0–0.1) constituted 48%, dropping to 25 and 14% at age 80 and 85. On average, over 10 years, the annual linear frailty score progression was approximately 6–7%. Among the least frail, 11% remained robust over 10 years. A higher frailty score was equivalent to being 5 to 10 years older. Mortality was substantially higher in the highest quartile compared to the lowest based on baseline frailty score; after 10 years, 48.7% had died vs 17.2% (p = 1.7 × 10−14). Mortality risk over the first 5 years was highest in the frailest (Q4 vs Q1; HRunadj 3.26 [1.86–5.73]; p < 0.001) and continued to be elevated at 10 years (HRunadj 3.58 [2.55–5.03]; p < 0.001). Frailty was associated with BMD after adjusting for BMI (overall p = 0.006; Q1 vs Q4 p = 0.003). Conclusions: The frailty index was highly predictive of mortality showing a threefold increased risk of death in the frailest both in a shorter and longer perspective. Only one in ten older women escaped progression after 10 years. Frailty and osteoporosis were associated.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone density, Community-dwelling, Frailty, Mortality, Women
in
Osteoporosis International
volume
29
issue
10
pages
2191 - 2199
publisher
Springer
external identifiers
  • scopus:85048368529
ISSN
0937-941X
DOI
10.1007/s00198-018-4593-7
language
English
LU publication?
yes
id
06995bc5-128a-4dc6-a525-14447eab5ab2
date added to LUP
2018-06-25 15:22:32
date last changed
2019-01-06 13:58:29
@article{06995bc5-128a-4dc6-a525-14447eab5ab2,
  abstract     = {<p>Summary: In community dwelling, 75-year-old women followed 10 years, a frailty index was created at each of three visits. Frailty score increased by ~ 6–7% annually. A higher frailty score was equivalent to being 5–10 years chronologically older. Frailty was associated with low bone density and higher risk of dying. Introduction: To understand the distribution of frailty among a population-based sample of older community-dwelling women, progression over 10 years, and association with mortality and osteoporosis. Methods: The study is performed in a cohort designed to investigate osteoporosis. The OPRA cohort consists of 75-year-old women, n = 1044 at baseline, and follow-up at age 80 and 85. A frailty index (scored from 0.0–1.0) based on deficits in health across multiple domains was created at all time-points; outcomes were mortality up to 15 years and femoral neck bone density. Results: At baseline, the proportion least frail, i.e., most robust (FI 0.0–0.1) constituted 48%, dropping to 25 and 14% at age 80 and 85. On average, over 10 years, the annual linear frailty score progression was approximately 6–7%. Among the least frail, 11% remained robust over 10 years. A higher frailty score was equivalent to being 5 to 10 years older. Mortality was substantially higher in the highest quartile compared to the lowest based on baseline frailty score; after 10 years, 48.7% had died vs 17.2% (p = 1.7 × 10<sup>−14</sup>). Mortality risk over the first 5 years was highest in the frailest (Q4 vs Q1; HR<sub>unadj</sub> 3.26 [1.86–5.73]; p &lt; 0.001) and continued to be elevated at 10 years (HR<sub>unadj</sub> 3.58 [2.55–5.03]; p &lt; 0.001). Frailty was associated with BMD after adjusting for BMI (overall p = 0.006; Q1 vs Q4 p = 0.003). Conclusions: The frailty index was highly predictive of mortality showing a threefold increased risk of death in the frailest both in a shorter and longer perspective. Only one in ten older women escaped progression after 10 years. Frailty and osteoporosis were associated.</p>},
  author       = {Bartosch, P. and McGuigan, F. E. and Akesson, K. E.},
  issn         = {0937-941X},
  keyword      = {Bone density,Community-dwelling,Frailty,Mortality,Women},
  language     = {eng},
  number       = {10},
  pages        = {2191--2199},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Progression of frailty and prevalence of osteoporosis in a community cohort of older women—a 10-year longitudinal study},
  url          = {http://dx.doi.org/10.1007/s00198-018-4593-7},
  volume       = {29},
  year         = {2018},
}