Frailty, fitness and late-life mortality in relation to chronological and biological age

By Arnold Mitnitski, J. Graham, Alexander J. Mogilner, Kenneth Rockwood. BMC Geriatrics, 2002

704 citations recorded by the source corpus.

BackgroundPeople age at remarkably different rates, but how to estimate trajectories of senescence is controversial.MethodsIn a secondary analysis of a representative cohort of Canadians aged 65 and over (n = 2914) we estimated a frailty index based on the proportion of 20 deficits observed in a structured clinical examination. The construct validity of the index was examined through its relationship to chronological age (CA). The criterion validity was examined in its ability to predict mortality, and in relation to other predictions about aging. From the frailty index, relative (to CA) fitness and frailty were estimated, as was an individual's biological age.ResultsThe average value of the frailty index increased with age in a log-linear relationship (r = 0.91; p < 0.001). In a Cox regression analysis, biological age was significantly more highly associated with death than chronological age. The average increase in the frailty index (i.e. the average accumulation of deficits) amongst those with no cognitive impairment was 3 per cent per year.ConclusionsThe frailty index is a sensitive predictor of survival. As the index includes items not traditionally related to adverse health outcomes, the finding is compatible with a view of frailty as the failure to integrate the complex responses required to maintain function.

Subfields: Aging, Geriatrics and Gerontology, Physiology

View Paper: https://www.semanticscholar.org/paper/21771444ecd5b048b1c8b9175700c69c5b4e5785

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Citations in the corpus

Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. (2004, methodology): “This strategy, comparable to the concept of allostatic load (32), has been pursued elsewhere using Canadian population estimates (48,49), including the CSHA (33,50,51).”
Frailty in relation to the accumulation of deficits. (2007, background): “most ambitious application of the frailty index is as a means of summarizing the commonly invoked concept – but less commonly quantified – notion of “biological age” (7,8,12, 48-50 ,).”
The Identification of Frailty: A Systematic Literature Review (2011, methodology): “Nonetheless, although lauding this approach, Ferrucci admitted “our gerontological souls are still bleeding”; the definition feels incomplete.46 Responding to this challenge, recent studies have examined the Fried components and added cognition and mood to the scale.6,7 Questions regarding the relat”
Frailty: an emerging research and clinical paradigm--issues and controversies. (2006, background): “The resulting measure of frailty is an indicator of an older person’s global health status (13,35).”
The I.A.N.A. task force on frailty assessment of older people in clinical practice (2008, neutral): “(25) Jones and colleagues also based their frailty index on the CGA.”
Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials (2015, background): “mon rule is that increasing age is related to decreasing well-being and increasing levels of frailty [2, 3], it is also true that individuals with the same chronological age can vary in health and functional status [4].”
Prevalence of Frailty in Community‐Dwelling Older Persons: A Systematic Review (2012, background): “Fried et al.(2) 2001 Cardiovascular Health Study United States 5,317 58 Yes Yes FFI 46.”
Frailty Syndrome: A Transitional State in a Dynamic Process (2009, methodology): “The Frailty Index, as proposed by Mitnitski et al. [”
Association of frailty with survival: a systematic literature review. (2013, background): “The other indices combine the accumulation of symptoms, diseases, and disabilities in one frailty index score (Carey et al., 2008, 2004; Drame et al., 2008; Fried et al., 1998; Garcia-Gonzalez et al., 2009; Inouye et al., 2003; Jones et al., 2005; Lee et al., 2006; Levine et al., 2007; Markides et a”