Frailty in Older Men: Prevalence, Progression, and Relationship with Mortality

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 8; pp. 1216 - 1223
• Main Authors: Cawthon, Peggy M., Marshall, Lynn M., Michael, Yvonne, Dam, Thuy-Tien, Ensrud, Kristine E., Barrett-Connor, Elizabeth, Orwoll, Eric S.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.08.2007; Blackwell; Wiley Subscription Services, Inc
• Subjects: Aged; aging; Biological and medical sciences; Cohort Studies; Cross-Sectional Studies; Disease Progression; Epidemiology; Frail Elderly - statistics & numerical data; frailty; General aspects; Geriatrics; Humans; Male; Medical sciences; Men; Miscellaneous; Mortality; Mortality - trends; Motor ability; Older people; Physical fitness; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; USA; Africa; Human; Senescence; Prognosis; Prevalence; Mortality; Ageing; Male; Epidemiology; frailty; Gerontology; Frailty in elderly; men; Adult; Evolution; aging; Elderly; Public health; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01259.x

OBJECTIVES: To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men. DESIGN: Cross‐sectional and prospective cohort study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand nine hundred ninety‐three community‐dwelling men aged 65 and older. MEASUREMENTS: Frailty was defined as three or more of the following: sarcopenia (low appendicular skeletal mass adjusted for height and body fat), weakness (grip strength), self‐reported exhaustion, low activity level, and slow walking speed. Prefrail men met one or two criteria; robust men had none. Follow‐up averaged 4.7 years. RESULTS: At baseline, 240 subjects (4.0%) were frail, 2,395 (40.0%) were prefrail, and 3,358 were robust (56.0%). Frail men were less healthy in most measures of self‐reported health than prefrail or robust men. Frailty was somewhat more common in African Americans (6.6%) and Asians (5.8%) than Caucasians (3.8%). At the second visit, men who were frail at baseline tended to remain frail (24.2%) or die (37.1%) or were unable to complete the follow‐up visit (26.2%); robust men tended to remain robust (54.4%). Frail men were approximately twice as likely to die as robust men (multivariate hazard ratio (MHR)=2.05, 95% confidence interval (CI)=1.55–2.72). Mortality risk for frail men was greater in all weight categories than for nonfrail men but was highest for normal‐weight frail men (MHR=2.39, 95% CI=1.51–3.79, P for interaction=.01). The relationship between frailty and mortality was somewhat stronger in younger men than older men (P for interaction=.01). CONCLUSION: Frailty in older men is associated with poorer health and a greater risk of mortality.