Frailty trajectories and associated factors in the years prior to death: evidence from 14 countries in the Survey of Health, Aging and Retirement in Europe

被引:7
|
作者
Jenkins, Natalie D. [1 ,2 ]
Welstead, Miles [1 ]
Stirland, Lucy [1 ]
Hoogendijk, Emiel O. [3 ]
Armstrong, Joshua J. [4 ]
Robitaille, Annie [5 ]
Muniz-Terrera, Graciela [1 ,6 ,7 ]
机构
[1] Univ Edinburgh, Edinburgh Dementia Prevent, Edinburgh, Scotland
[2] Univ Glasgow, Glasgow Brain Injury Res Grp, Glasgow, Scotland
[3] Amsterdam UMC Locat VU Univ Med Ctr, Amsterdam Publ Hlth Res Inst, Dept Epidemiol & Biostat, Amsterdam, Netherlands
[4] Lakehead Univ, Dept Hlth Sci, Thunder Bay, ON, Canada
[5] Univ Ottawa, Fac Hlth Sci, Ottawa, ON, Canada
[6] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR USA
[7] Ohio Univ, Dept Social Med, Athens, OH USA
基金
英国医学研究理事会; 美国国家卫生研究院; 加拿大健康研究院;
关键词
Frailty trajectories; Longitudinal data; Mortality; End of life care; Age-related changes; SEX-DIFFERENCES; SOCIOECONOMIC POSITION; DEFICIT ACCUMULATION; RELATIVE FITNESS; OLDER; INDEX; PROGRESSION; MORTALITY; DECLINE; MEN;
D O I
10.1186/s12877-023-03736-1
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
BackgroundAge-related changes in frailty have been documented in the literature. However, the evidence regarding changes in frailty prior to death is scarce. Understanding patterns of frailty progression as individuals approach death could inform care and potentially lead to interventions to improve individual's well-being at the end of life. In this paper, we estimate the progression of frailty in the years prior to death.MethodsUsing data from 8,317 deceased participants of the Survey of Health, Ageing, and Retirement in Europe, we derived a 56-item Frailty Index. In a coordinated analysis of repeated measures of the frailty index in 14 countries, we fitted growth curve models to estimate trajectories of frailty as a function of distance to death controlling both the level and rate of frailty progression for age, sex, years to death and dementia diagnosis.ResultsAcross all countries, frailty before death progressed linearly. In 12 of the 14 countries included in our analyses, women had higher levels of frailty close to the time of death, although they progressed at a slower rate than men (e.g. Switzerland (-0.008, SE = 0.003) and Spain (-0.004, SE = 0.002)). Older age at the time of death and incident dementia were associated with higher levels and increased rate of change in frailty, whilst higher education was associated with lower levels of frailty in the year preceding death (e.g. Denmark (0.000, SE = 0.001)).ConclusionThe progression of frailty before death was linear. Our results suggest that interventions aimed at slowing frailty progression may need to be different for men and women. Further longitudinal research on individual patterns and changes of frailty is warranted to support the development of personalized care pathways at the end of life.
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页数:12
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