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.
(Less)
- author
- Bartosch, P.
LU
; McGuigan, F. E.
LU
and Akesson, K. E.
LU
- organization
- publishing date
- 2018-10
- 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
-
- pmid:29947868
- 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
- 2024-07-09 18:27:27
@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 < 0.001) and continued to be elevated at 10 years (HR<sub>unadj</sub> 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.</p>}},
author = {{Bartosch, P. and McGuigan, F. E. and Akesson, K. E.}},
issn = {{0937-941X}},
keywords = {{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}},
doi = {{10.1007/s00198-018-4593-7}},
volume = {{29}},
year = {{2018}},
}