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Frailty, hospitalization, and progression of disability in a cohort of disabled older women.
Am J Med. 2005 Nov; 118(11):1225-31.AJ

Abstract

PURPOSE

To determine the association between a previously validated frailty phenotype and the development of new-onset dependence in activities of daily living, independent of hospitalizations and other established predictors of disability.

SUBJECTS

Seven hundred and forty-nine women enrolled in the Women's Health and Aging Study-I who were independent in all activities in daily living when enrolled in the cohort.

METHODS

Assessments and interviews were conducted through home visits at 6-month intervals for 3 years. Frailty was classified using a validated phenotype (> or =3 of the following: weight loss, exhaustion, slow walking, sedentariness, and weak grip), and hospitalizations were identified by self-report. Grouped-time proportional hazard models assessed associations among frailty, hospitalization, and the development of dependence in activities in daily living, adjusting for other factors.

RESULTS

Twenty-five percent of the cohort (186/749) were frail at baseline; 56% (104/186) of frail versus 20% (23/117) of nonfrail women developed dependence in activities in daily living (P <.001). In multivariate analysis, frailty was independently associated with the development of dependence in activities in daily living (hazard ratio [HR] = 2.2; 95% confidence interval [CI]: 1.4 to 3.6), adjusting for hospitalization status, age, race, education, baseline functional status, cognition, depressive symptoms, number of chronic diseases, and self-reported health status. Additionally, a dose-response relationship existed between the number of frailty criteria that a woman had and the hazard of subsequent dependence in activities in daily living.

CONCLUSION

Frailty, conceptualized as an underlying vulnerability, and hospitalization, which marks an acute deterioration in health, were strongly and independently associated with new-onset dependence in activities in daily living. Additional research is needed to determine if dependence can be minimized by targeting resources and programs to frail older persons.

Authors+Show Affiliations

Division of Geriatric Medicine and Gerontology, Center on Aging and Health, National Institute on Aging, Baltimore, Md, USA. cboyd1@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

16271906

Citation

Boyd, Cynthia M., et al. "Frailty, Hospitalization, and Progression of Disability in a Cohort of Disabled Older Women." The American Journal of Medicine, vol. 118, no. 11, 2005, pp. 1225-31.
Boyd CM, Xue QL, Simpson CF, et al. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118(11):1225-31.
Boyd, C. M., Xue, Q. L., Simpson, C. F., Guralnik, J. M., & Fried, L. P. (2005). Frailty, hospitalization, and progression of disability in a cohort of disabled older women. The American Journal of Medicine, 118(11), 1225-31.
Boyd CM, et al. Frailty, Hospitalization, and Progression of Disability in a Cohort of Disabled Older Women. Am J Med. 2005;118(11):1225-31. PubMed PMID: 16271906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frailty, hospitalization, and progression of disability in a cohort of disabled older women. AU - Boyd,Cynthia M, AU - Xue,Qian-Li, AU - Simpson,Crystal F, AU - Guralnik,Jack M, AU - Fried,Linda P, PY - 2004/12/28/received PY - 2005/01/04/revised PY - 2005/01/20/accepted PY - 2005/11/8/pubmed PY - 2005/12/13/medline PY - 2005/11/8/entrez SP - 1225 EP - 31 JF - The American journal of medicine JO - Am J Med VL - 118 IS - 11 N2 - PURPOSE: To determine the association between a previously validated frailty phenotype and the development of new-onset dependence in activities of daily living, independent of hospitalizations and other established predictors of disability. SUBJECTS: Seven hundred and forty-nine women enrolled in the Women's Health and Aging Study-I who were independent in all activities in daily living when enrolled in the cohort. METHODS: Assessments and interviews were conducted through home visits at 6-month intervals for 3 years. Frailty was classified using a validated phenotype (> or =3 of the following: weight loss, exhaustion, slow walking, sedentariness, and weak grip), and hospitalizations were identified by self-report. Grouped-time proportional hazard models assessed associations among frailty, hospitalization, and the development of dependence in activities in daily living, adjusting for other factors. RESULTS: Twenty-five percent of the cohort (186/749) were frail at baseline; 56% (104/186) of frail versus 20% (23/117) of nonfrail women developed dependence in activities in daily living (P <.001). In multivariate analysis, frailty was independently associated with the development of dependence in activities in daily living (hazard ratio [HR] = 2.2; 95% confidence interval [CI]: 1.4 to 3.6), adjusting for hospitalization status, age, race, education, baseline functional status, cognition, depressive symptoms, number of chronic diseases, and self-reported health status. Additionally, a dose-response relationship existed between the number of frailty criteria that a woman had and the hazard of subsequent dependence in activities in daily living. CONCLUSION: Frailty, conceptualized as an underlying vulnerability, and hospitalization, which marks an acute deterioration in health, were strongly and independently associated with new-onset dependence in activities in daily living. Additional research is needed to determine if dependence can be minimized by targeting resources and programs to frail older persons. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/16271906/Frailty_hospitalization_and_progression_of_disability_in_a_cohort_of_disabled_older_women_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00168-3 DB - PRIME DP - Unbound Medicine ER -