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Titolo:
Frailty in older adults: Evidence for a phenotype
Autore:
Fried, LP; Tangen, CM; Walston, J; Newman, AB; Hirsch, C; Gottdiener, J; Seeman, T; Tracy, R; Kop, WJ; Burke, G; McBurnie, MA;
Indirizzi:
Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA Wake Forest Univ Winston Salem NC USA ray Sch Med, Winston Salem, NC USA Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA Uniformed Serv Univ Hlth Sci Bethesda MD USA 20814 Bethesda, MD 20814 USA Univ Vermont, Burlington, VT USA Univ Vermont Burlington VT USAUniv Vermont, Burlington, VT USA Univ Calif Los Angeles, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA St Francis Hosp, Roslyn, NY USA St Francis Hosp Roslyn NY USASt Francis Hosp, Roslyn, NY USA Univ Calif Davis, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CAUSA 95817 Davis, Sacramento, CA 95817 USA Univ Pittsburgh, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 tsburgh, Pittsburgh, PA 15260 USA Univ Washington, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 iv Washington, Seattle, WA 98195 USA Johns Hopkins Med Inst, Baltimore, MD 21205 USA Johns Hopkins Med Inst Baltimore MD USA 21205 st, Baltimore, MD 21205 USA
Titolo Testata:
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
fascicolo: 3, volume: 56, anno: 2001,
pagine: M146 - M156
SICI:
1079-5006(200103)56:3<M146:FIOAEF>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
FAILURE-TO-THRIVE; CARDIOVASCULAR HEALTH; ELDERLY PEOPLE; FUNCTIONAL PERFORMANCE; VITAL EXHAUSTION; CONTROLLED TRIAL; FOOD-INTAKE; EXERCISE; MEN; AGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Life Sciences
Citazioni:
53
Recensione:
Indirizzi per estratti:
Indirizzo: Fried, LP CHS Coordinating Ctr, Century Sq Bldg,1501 4th Ave,Suite 2105, Seattle, WA98101 USA CHS Coordinating Ctr Century Sq Bldg,1501 4th Ave,Suite2105 Seattle WA USA 98101
Citazione:
L.P. Fried et al., "Frailty in older adults: Evidence for a phenotype", J GERONT A, 56(3), 2001, pp. M146-M156

Abstract

Background Frailty is considered highly prevalent in old age and to conferhigh risk for falls, disability, hospitalization, and mortality. Frailty has been considered synonymous with disability, comorbidity, and other characteristics, but it is recognized that it may have a biologic basis and he adistinct clinical syndrome. A standardized definition has not yet been established. Methods. To develop and operationalize a phenotype of frailty in older adults and assess concurrent and predictive validity, the study used data fromthe Cardiovascular Health Study. Participants were 5,317 men and women 65 years and older (4,735 from an original cohort recruited in 1989-90 and 582from an African American cohort recruited in 1992-93). Both cohorts received almost identical baseline evaluations and 7 and 4 years of follow-up, respectively, with annual examinations and surveillance for outcomes including incident disease, hospitalization, falls, disability, and mortality. Results, Frailty was defined as a clinical syndrome in which three or moreof the following criteria were present: unintentional weight loss (10 lbs in past year), self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity. The overall prevalence of frailty inthis community-dwelling population was 6.9% it increased with age and was greater in women than men. Four-year incidence was 7.2%. Frailty was associated with being African American. having lower education and income, poorerhealth, and having higher rates of comorbid chronic diseases and disability. There was overlap, but not concordance, in the cooccurrence of frailty, comorbidity, and disability. This frailty phenotype was independently predictive lover 3 years) of incident falls, worsening mobility or ADL disability, hospitalization. and death, with hazard ratios ranging from 1.82 to 4.46, unadjusted, and 1.29-2.24, adjusted for a number of health, disease, and social characteristics predictive of 5-year mortality. Intermediate frailtystatus, as indicated by the presence of one or two criteria, showed intermediate risk of these outcomes as well as increased risk of becoming Frail over 31 years of follow-up (odds ratios for incident frailty = 4.51 unadjusted and 2.63 adjusted for covariates, compared to those with no frailty criteria at baseline). Conclusion. This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition. It also finds that there is an intermediatestage identifying those at high risk of frailty. Finally, it provides evidence that frailty is not synonymous with either comorbidity or disability, bur comorbidity is an etiologic risk factor for, and disability is an outcome of, frailty. This provides a potential basis for clinical assessment forthose who are frail or at risk, and for future research to develop interventions for frailty based on a standardized ascertainment of frailty.

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Documento generato il 01/06/20 alle ore 02:29:52