Trajectories of frailty with aging: Coordinated analysis of five longitudinal studies

Natalie D. Jenkins, Emiel O. Hoogendijk, Joshua J. Armstrong, Nathan A. Lewis, Janice M. Ranson, Judith J.M. Rijnhart, Tamer Ahmed, Ahmed Ghachem, Donncha S. Mullin, Eva Ntanasi, Miles Welstead, Mohammad Auais, David A. Bennett, Stefania Bandinelli, Matteo Cesari, Luigi Ferrucci, Simon D. French, Martijn Huisman, David J. Llewellyn, Nikolaos ScarmeasAndrea M. Piccinin, Scott M. Hofer, Graciela Muniz-Terrera*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background and Objectives: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education. Research Design and Methods: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term. Results: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves. Discussion and Implications: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

Original languageEnglish
Article numberigab059
JournalInnovation in Aging
Issue number2
Early online date15 Jan 2022
Publication statusPublished - 27 Feb 2022

Keywords / Materials (for Non-textual outputs)

  • Age-related changes
  • Latent growth curve
  • Longitudinal


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