Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study
Abstract Background The frailty index (FI) is a well-recognized measurement for risk stratification in older people. Among middle-aged and older people, we examined the prospective association between the FI and mortality as well as its course over time in relation to multimorbidity and specific dis...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Medicine |
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| Online Access: | https://doi.org/10.1186/s12916-021-01904-x |
| _version_ | 1818410490179616768 |
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| author | R. C. Oude Voshaar H. W. Jeuring M. K. Borges R. H. S. van den Brink R. M. Marijnissen E. O. Hoogendijk B. van Munster I. Aprahamian |
| author_facet | R. C. Oude Voshaar H. W. Jeuring M. K. Borges R. H. S. van den Brink R. M. Marijnissen E. O. Hoogendijk B. van Munster I. Aprahamian |
| author_sort | R. C. Oude Voshaar |
| collection | DOAJ |
| description | Abstract Background The frailty index (FI) is a well-recognized measurement for risk stratification in older people. Among middle-aged and older people, we examined the prospective association between the FI and mortality as well as its course over time in relation to multimorbidity and specific disease clusters. Methods A frailty index (FI) was constructed based on either 64 (baseline only) or 35 health deficits (baseline and follow-up) among people aged ≥ 40 years who participated in LifeLines, a prospective population-based cohort living in the Northern Netherlands. Among 92,640 participants, multivariable Cox proportional hazard models were fitted to study the hazard ratio (HR) of the FI at baseline, as well as for 10 chronic disease clusters for all-cause mortality over a 10-year follow-up. Among 55,426 participants, linear regression analyses were applied to study the impact of multimorbidity and of specific chronic disease clusters (independent variables) on the change of frailty over a 5-year follow-up, adjusted for demographic and lifestyle characteristics. Results The FI predicted mortality independent of multimorbidity and specific disease clusters, with the highest impact in people with either endocrine, lung, or heart diseases. Adjusted for demographic and lifestyle characteristics, all chronic disease clusters remained independently associated with an accelerated increase of frailty over time. Conclusions Frailty may be seen as a final common pathway for premature death due to chronic diseases. Our results suggest that initiating frailty prevention at middle age, when the first chronic diseases emerge, might be relevant from a public health perspective. |
| first_indexed | 2024-12-14T10:16:21Z |
| format | Article |
| id | doaj.art-59c4cc25e1b645ba9d495271798496ec |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-14T10:16:21Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-59c4cc25e1b645ba9d495271798496ec2022-12-21T23:06:49ZengBMCBMC Medicine1741-70152021-02-0119111010.1186/s12916-021-01904-xCourse of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort studyR. C. Oude Voshaar0H. W. Jeuring1M. K. Borges2R. H. S. van den Brink3R. M. Marijnissen4E. O. Hoogendijk5B. van Munster6I. Aprahamian7Department of Psychiatry, University of Groningen, University Medical Center GroningenDepartment of Psychiatry, University of Groningen, University Medical Center GroningenDepartment and Institute of Psychiatry, University of São Paulo (USP)Department of Psychiatry, University of Groningen, University Medical Center GroningenDepartment of Psychiatry, University of Groningen, University Medical Center GroningenDepartment of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC - location VU University Medical CenterDepartment of Internal Medicine, University of Groningen, University Medical Center GroningenDepartment of Psychiatry, University of Groningen, University Medical Center GroningenAbstract Background The frailty index (FI) is a well-recognized measurement for risk stratification in older people. Among middle-aged and older people, we examined the prospective association between the FI and mortality as well as its course over time in relation to multimorbidity and specific disease clusters. Methods A frailty index (FI) was constructed based on either 64 (baseline only) or 35 health deficits (baseline and follow-up) among people aged ≥ 40 years who participated in LifeLines, a prospective population-based cohort living in the Northern Netherlands. Among 92,640 participants, multivariable Cox proportional hazard models were fitted to study the hazard ratio (HR) of the FI at baseline, as well as for 10 chronic disease clusters for all-cause mortality over a 10-year follow-up. Among 55,426 participants, linear regression analyses were applied to study the impact of multimorbidity and of specific chronic disease clusters (independent variables) on the change of frailty over a 5-year follow-up, adjusted for demographic and lifestyle characteristics. Results The FI predicted mortality independent of multimorbidity and specific disease clusters, with the highest impact in people with either endocrine, lung, or heart diseases. Adjusted for demographic and lifestyle characteristics, all chronic disease clusters remained independently associated with an accelerated increase of frailty over time. Conclusions Frailty may be seen as a final common pathway for premature death due to chronic diseases. Our results suggest that initiating frailty prevention at middle age, when the first chronic diseases emerge, might be relevant from a public health perspective.https://doi.org/10.1186/s12916-021-01904-xMultimorbidityFrailtyFrailty indexMortalityBiological aging |
| spellingShingle | R. C. Oude Voshaar H. W. Jeuring M. K. Borges R. H. S. van den Brink R. M. Marijnissen E. O. Hoogendijk B. van Munster I. Aprahamian Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study BMC Medicine Multimorbidity Frailty Frailty index Mortality Biological aging |
| title | Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study |
| title_full | Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study |
| title_fullStr | Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study |
| title_full_unstemmed | Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study |
| title_short | Course of frailty stratified by physical and mental multimorbidity patterns: a 5-year follow-up of 92,640 participants of the LifeLines cohort study |
| title_sort | course of frailty stratified by physical and mental multimorbidity patterns a 5 year follow up of 92 640 participants of the lifelines cohort study |
| topic | Multimorbidity Frailty Frailty index Mortality Biological aging |
| url | https://doi.org/10.1186/s12916-021-01904-x |
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