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Trajectories of phenotypical frailty over a decade in young–old community-dwelling adults: results from the Lc65+ study
  1. Sarah Fustinoni,
  2. Brigitte Santos-Eggimann,
  3. Yves Henchoz
  1. Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
  1. Correspondence to Mrs Sarah Fustinoni, Center for Primary Care and Public Health, Lausanne, Switzerland; sarah.fustinoni{at}unisante.ch

Abstract

Background Few studies have examined the frailty trajectories of young–old adults using Fried frailty phenotype. Dropouts due to death were rarely taken into account. This longitudinal study aimed to identify trajectories with and without adjustment for non-random attrition and to analyse related factors.

Methods We used the first two samples of community-dwelling people in the Lausanne cohort 65+. Frailty phenotype was assessed at age 66–71 years and every third year over 10 years. A group-based trajectory modelling—first without and then with adjustment for non-random attrition—identified trajectories among all individuals with at least two observations (n=2286), excluding dropouts for reasons other than death. Multinomial logistic regressions estimated independent effects of participants’ baseline characteristics.

Results We identified three frailty trajectories (low, medium and high). Participants in the highest trajectory had a higher mortality over 10 years. (Pre)frailty at baseline was the main factor associated with adverse trajectories. Smoking, obesity, comorbidity and negative self-perceived health were associated with unfavourable trajectories independently of baseline frailty, while social engagement was related to the lowest frailty trajectory. Ignoring transitions to death attenuated the estimated effects of age on trajectories.

Conclusions Fried frailty phenotype should be assessed in individuals aged late 60s as it is strongly associated with frailty trajectories in the following decade of their life. Lifetime prevention of behavioural risk factors such as smoking and obesity is the strategy most likely to influence the development of frailty in older populations. Furthermore, our results underline social engagement as an important area of interest for future research.

  • epidemiology of ageing
  • longitudinal studies
  • cohort studies
  • mortality

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors BS-E created and conducted the Lausanne cohort 65+ project. BS-E, SF and YH designed the study; SF performed the data analysis; SF and BS-E drafted the manuscript. All authors interpreted the results, provided critical revisions and approved the final version of the manuscript.

  • Funding The Lc65+ study has been supported by the University of Lausanne Centre for Primary Care and Public Health (Unisanté); University of Lausanne Hospital Centre; Canton de Vaud Department of Public Health; City of Lausanne; Loterie Romande (research grants 2006–2008 and 2018–2019); Lausanne University Faculty of Biology and Medicine (multidisciplinary research grant 2006); Swiss National Foundation for Scientific Research (grant 3247B0-120795/1); and Fondation Médecine Sociale et Préventive, Lausanne. Sponsors did not intervene in the design, execution, analysis and interpretation of the data, nor in the writing of this study.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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