Early frailty transition predicts 15-year mortality among nondisabled older Mexican Americans

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Abstract

Purpose: To investigate the effect of early frailty transitions on 15-year mortality risk. Methods: Longitudinal data analysis of the Hispanic Established Populations for the Epidemiological Study of the Elderly involving 1171 community-dwelling Mexican Americans aged ≥67 years and older. Frailty was determined using the modified frailty phenotype, including unintentional weight loss, weakness, self-reported exhaustion, and slow walking speed. Participants were defined at baseline as nonfrail, prefrail, or frail and divided into nine transition groups, during a 3-year observation period. Results: Mean age was 77.0 years (standard deviation [SD] = 5.3) and 59.1% were female. Participants who transitioned from prefrail to frail (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.23–2.28), frail to prefrail (HR = 1.54, 95% CI = 1.05–2.28); or who remained frail (HR = 1.72, 95% CI = 1.21–2.44), had significant higher 15-year mortality risk than those who remained nonfrail. Participants transitioning from frail to nonfrail had a similar 15-year mortality risk as those who remained nonfrail (HR = 0.96, 95% CI = 0.53–1.72). Weight loss and slow walking speed were associated with transitions to frailty. Conclusions: An early transition from frail to nonfrail in older Mexican Americans was associated with a 4% decrease in mortality compared with those who remained nonfrail, although this difference was not statistically significant. Additional longitudinal research is needed to understand positive transitions in frailty.

Original languageEnglish (US)
JournalAnnals of Epidemiology
DOIs
StateAccepted/In press - Jan 1 2018

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Confidence Intervals
Mortality
Weight Loss
Independent Living
Hispanic Americans
Epidemiologic Studies
Observation
Phenotype
Research
Population
Walking Speed

Keywords

  • Frail Elderly
  • Mexican Americans
  • Mortality

ASJC Scopus subject areas

  • Epidemiology

Cite this

@article{b47c0a75e3294ff99d7f3d551711da6a,
title = "Early frailty transition predicts 15-year mortality among nondisabled older Mexican Americans",
abstract = "Purpose: To investigate the effect of early frailty transitions on 15-year mortality risk. Methods: Longitudinal data analysis of the Hispanic Established Populations for the Epidemiological Study of the Elderly involving 1171 community-dwelling Mexican Americans aged ≥67 years and older. Frailty was determined using the modified frailty phenotype, including unintentional weight loss, weakness, self-reported exhaustion, and slow walking speed. Participants were defined at baseline as nonfrail, prefrail, or frail and divided into nine transition groups, during a 3-year observation period. Results: Mean age was 77.0 years (standard deviation [SD] = 5.3) and 59.1{\%} were female. Participants who transitioned from prefrail to frail (hazard ratio [HR] = 1.68, 95{\%} confidence interval [CI] = 1.23–2.28), frail to prefrail (HR = 1.54, 95{\%} CI = 1.05–2.28); or who remained frail (HR = 1.72, 95{\%} CI = 1.21–2.44), had significant higher 15-year mortality risk than those who remained nonfrail. Participants transitioning from frail to nonfrail had a similar 15-year mortality risk as those who remained nonfrail (HR = 0.96, 95{\%} CI = 0.53–1.72). Weight loss and slow walking speed were associated with transitions to frailty. Conclusions: An early transition from frail to nonfrail in older Mexican Americans was associated with a 4{\%} decrease in mortality compared with those who remained nonfrail, although this difference was not statistically significant. Additional longitudinal research is needed to understand positive transitions in frailty.",
keywords = "Frail Elderly, Mexican Americans, Mortality",
author = "Chih-ying Li and {Al Snih al snih}, Soham and Amol Karmarkar and Kyriakos Markides and Kenneth Ottenbacher",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.annepidem.2018.03.021",
language = "English (US)",
journal = "Annals of Epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Early frailty transition predicts 15-year mortality among nondisabled older Mexican Americans

AU - Li, Chih-ying

AU - Al Snih al snih, Soham

AU - Karmarkar, Amol

AU - Markides, Kyriakos

AU - Ottenbacher, Kenneth

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose: To investigate the effect of early frailty transitions on 15-year mortality risk. Methods: Longitudinal data analysis of the Hispanic Established Populations for the Epidemiological Study of the Elderly involving 1171 community-dwelling Mexican Americans aged ≥67 years and older. Frailty was determined using the modified frailty phenotype, including unintentional weight loss, weakness, self-reported exhaustion, and slow walking speed. Participants were defined at baseline as nonfrail, prefrail, or frail and divided into nine transition groups, during a 3-year observation period. Results: Mean age was 77.0 years (standard deviation [SD] = 5.3) and 59.1% were female. Participants who transitioned from prefrail to frail (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.23–2.28), frail to prefrail (HR = 1.54, 95% CI = 1.05–2.28); or who remained frail (HR = 1.72, 95% CI = 1.21–2.44), had significant higher 15-year mortality risk than those who remained nonfrail. Participants transitioning from frail to nonfrail had a similar 15-year mortality risk as those who remained nonfrail (HR = 0.96, 95% CI = 0.53–1.72). Weight loss and slow walking speed were associated with transitions to frailty. Conclusions: An early transition from frail to nonfrail in older Mexican Americans was associated with a 4% decrease in mortality compared with those who remained nonfrail, although this difference was not statistically significant. Additional longitudinal research is needed to understand positive transitions in frailty.

AB - Purpose: To investigate the effect of early frailty transitions on 15-year mortality risk. Methods: Longitudinal data analysis of the Hispanic Established Populations for the Epidemiological Study of the Elderly involving 1171 community-dwelling Mexican Americans aged ≥67 years and older. Frailty was determined using the modified frailty phenotype, including unintentional weight loss, weakness, self-reported exhaustion, and slow walking speed. Participants were defined at baseline as nonfrail, prefrail, or frail and divided into nine transition groups, during a 3-year observation period. Results: Mean age was 77.0 years (standard deviation [SD] = 5.3) and 59.1% were female. Participants who transitioned from prefrail to frail (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.23–2.28), frail to prefrail (HR = 1.54, 95% CI = 1.05–2.28); or who remained frail (HR = 1.72, 95% CI = 1.21–2.44), had significant higher 15-year mortality risk than those who remained nonfrail. Participants transitioning from frail to nonfrail had a similar 15-year mortality risk as those who remained nonfrail (HR = 0.96, 95% CI = 0.53–1.72). Weight loss and slow walking speed were associated with transitions to frailty. Conclusions: An early transition from frail to nonfrail in older Mexican Americans was associated with a 4% decrease in mortality compared with those who remained nonfrail, although this difference was not statistically significant. Additional longitudinal research is needed to understand positive transitions in frailty.

KW - Frail Elderly

KW - Mexican Americans

KW - Mortality

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U2 - 10.1016/j.annepidem.2018.03.021

DO - 10.1016/j.annepidem.2018.03.021

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SN - 1047-2797

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