Frailty: Emergence and consequences in women aged 65 and older in the women's health initiative observational study

被引:767
|
作者
Woods, NF
LaCroix, AZ
Gray, SL
Aragaki, A
Cochrane, BB
Brunner, RL
Masaki, K
Murray, A
Newman, AB
机构
[1] Univ Washington, Sch Nursing, Seattle, WA 98195 USA
[2] Univ Washington, Sch Pharm, Geriatr Pharm Program, Seattle, WA 98195 USA
[3] Fred Hutchinson Canc Res Ctr, Womens Hlth Initiat, Seattle Clin Ctr, Seattle, WA 98104 USA
[4] Fred Hutchinson Canc Res Ctr, Womens Hlth Initiat, Clin Coordinat Ctr, Seattle, WA 98104 USA
[5] Univ Nevada, Sch Med, Dept Family & Community Med, Reno, NV 89557 USA
[6] Univ Hawaii, John A Burns Sch Med, Dept Geriatr Med, Honolulu, HI 96822 USA
[7] Hennepin Cty Med Ctr, Dept Med, Nephrol Analyt Serv, Minneapolis, MN 55415 USA
[8] Univ Pittsburgh, Dept Med & Epidemiol, Healthy Aging Res Program, Pittsburgh, PA 15260 USA
关键词
frailty; activities of daily living; ethnicity; disability; postmenopausal women; Women's Health Initiative;
D O I
10.1111/j.1532-5415.2005.53405.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To define frailty using simple indicators; to identify risk factors for frailty as targets for prevention; and to investigate the predictive validity of this frailty classification for death, hospitalization, hip fracture, and activity of daily living (ADL) disability. DESIGN: Prospective study, the Women's Health Initiative Observational Study. SETTING: Forty U.S. clinical centers. PARTICIPANTS: Forty thousand six hundred fifty-seven women aged 65 to 79 at baseline. MEASUREMENTS: Components of frailty included self-reported muscle weakness/impaired walking, exhaustion, low physical activity, and unintended weight loss between baseline and 3 years of follow-up. Death, hip fractures, ADL disability, and hospitalizations were ascertained during an average of 5.9 years of follow-up. RESULTS: Baseline frailty was classified in 16.3% of participants, and incident frailty at 3-years was 14.8%. Older age, chronic conditions, smoking, and depressive symptom score were positively associated with incident frailty, whereas income, moderate alcohol use, living alone, and self-reported health were inversely associated. Being underweight, overweight, or obese all carried significantly higher risk of frailty than normal weight. Baseline frailty independently predicted risk of death (hazard ratio (HR)=1.71, 95% confidence interval (CI)=1.48-1.97), hip fracture (HR=1.57, 95% CI=1.11-2.20), ADL disability (odds ratio (OR)=3.15, 95% CI=2.47-4.02), and hospitalizations (OR=1.95, 95% CI=1.72-2.22) after adjustment for demographic characteristics, health behaviors, disability, and comorbid conditions. CONCLUSION: These results support the robustness of the concept of frailty as a geriatric syndrome that predicts several poor outcomes in older women. Underweight, obesity, smoking, and depressive symptoms are strongly associated with the development of frailty and represent important targets for prevention.
引用
收藏
页码:1321 / 1330
页数:10
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