Frailty and the prediction of dependence and mortality in low- and middle-income countries: a 10/66 population-based cohort study

• DOI: 10.1186/s12916-015-0378-4
• Publication Date: 2015-06-10T16:26:14Z
• Authors: Jotheeswaran AT; Renata Bryce; Matthew Prina; Daisy Acosta; Cleusa P Ferri; Mariella Guerra; Yueqin Huang; Juan J. Llibre Ro...; Aquiles Salas; Ana Luisa Sosa; Joseph D. Williams; Michael E. Dewey; Isaac Acosta; Zhaorui Liu; John Beard; Martin Prince
• Keywords: Male; 570; China; Economics and Econometrics; Physiology; Frail Elderly; Population; 610; India; Social Sciences; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Sociology; Frailty in Older Adults and Geriatric Care; Health Sciences; Humans; Disabled Persons; Sarcopenia: Definition, Diagnosis, and Implications; Developing Countries; Mexico; Internal medicine; Aged; Demography; Medicine(all); 2. Zero hunger; Frailty; Malnutrition; Cohort; 1. No poverty; FOS: Sociology; 3. Good health; Economics, Econometrics and Finance; Latin America; Health Economics and Quality of Life Assessment; Environmental health; Socioeconomic Factors; FOS: Biological sciences; Chronic Disease; Medicine; Female; Geriatrics and Gerontology; Cohort study; Gerontology; Research Article

In countries with high incomes, frailty indicators predict adverse outcomes in older people, despite a lack of consensus on definition or measurement. We tested the predictive validity physical and multidimensional phenotypes settings Latin America, India, China. Population-based cohort studies were conducted catchment area sites Cuba, Dominican Republic, Venezuela, Mexico, Peru, Seven indicators, namely gait speed, self-reported exhaustion, weight loss, low energy expenditure, undernutrition, cognitive, sensory impairment assessed to estimate phenotypes. Mortality onset dependence ascertained after median 3.9 years. Overall, 13,924 people at baseline, 47,438 person-years follow-up for mortality 30,689 dependence. Both predicted mortality, even adjusting chronic diseases disability, little heterogeneity effect among sites. However, population attributable fractions (PAF) summarising etiologic force highest aggregate individual as opposed either number dichotomised The all seven provided best overall prediction (weighted mean PAF 41.8 % 38.3 mortality). While underactivity, slow walking cognitive both outcomes, whereas undernutrition only Exhaustion neither outcome. Simply identify risk beyond information by disease diagnoses disability. Frailty is likely be multidimensional. A better understanding construct pathways could inform assessment intervention prevent manage frail potential add life years, years life.