A limit to frailty in very old, community-dwelling people: a secondary analysis of the Chinese longitudinal health and longevity study

Bennett, Stephanie L.; Song, Xiaowei; Mitnitski, Arnold; Rockwood, Kenneth

doi:10.1093/ageing/afs180

Cited by 84 publications

(72 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar findings have been shown by a recent study on Chinese sample aged 80+ years (19). Even so, previous studies have not explored the possible gender differences in the FI limits and thus not taken into account the difference in mortality and healthy life expectancy between men and women (7,15,18,19, 23–25). Using data from the Beijing Longitudinal Study of Aging, we have evaluated aging by applying the FI approach in China (14, 26).…”

supporting

confidence: 92%

“…This reflected in the different FI limit values between men and women. An empirical 99% FI limit of approximately 0.70 was seen in women, as reported in previous analyses that do not separate limit by sex (18,19). In fact, as shown here, the empirical 99% FI limit of men was notably lower than 0.7.…”

Section: Discussionsupporting

confidence: 71%

“…One intriguing finding from work with the FI is that there appears to be an empirical limit to the accumulation of deficits in older adults, as suggested by the reliability theory of aging (7,15,18,19). According to this theory, humans represent redundant systems, with certain numbers of irreplaceable elements that deteriorate over time.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Sex Differences in the Limit to Deficit Accumulation in Late Middle-Aged and Older Chinese People: Results From the Beijing Longitudinal Study of Aging

Shi

Yang

Song

et al. 2013

The Journals of Gerontology Series A: Biological Sciences and M

View full text Add to dashboard Cite

Background.On average, as people age, they accumulate more health deficits and have an increased risk of death. The deficit accumulation–based frailty index (FI) can quantify health and its outcomes in aging. Previous studies have suggested that women show higher FI values than men and that the highest FI score (the “limit to frailty”) occurs at a value of FI ~ 0.7. Even so, gender differences in the limit to frailty have not been reported.Methods.Data for this analysis were obtained from the Beijing Longitudinal Study of Aging that involved 3,257 community-dwelling Chinese people, aged 55+ years at baseline. The main outcome measure was 5-year mortality. An FI consisting of 35 health-related variables was constructed. The absolute and 99% FI limits were calculated for different age groups and analyzed by sex.Results.The mean level of the FI increased with age and was lower in men than in women (F = 67.87, p < .001). The 99% FI limit leveled off slightly earlier with a relatively lower value in men (60 years; 0.44 ± 0.02) compared with that in women (65 years; 0.52 ± 0.04). The highest absolute FI value was 0.61 in men and 0.69 in women. In both groups, people with an FI greater than or equal to the 99% limit showed close to 100% mortality by 5 years.Conclusion.Compared with men, women appeared to better tolerate deficits in health, yielding both relatively lower mortality and higher limit values to the FI. Even so, the FI did not exceed 0.7 in any individual.

show abstract

supporting

confidence: 92%

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Sex Differences in the Limit to Deficit Accumulation in Late Middle-Aged and Older Chinese People: Results From the Beijing Longitudinal Study of Aging

Shi

Yang

Song

et al. 2013

The Journals of Gerontology Series A: Biological Sciences and M

View full text Add to dashboard Cite

show abstract

“…This too will vary by the population from which the sample is taken. For these reasons, we see a significant value to the frailty index in including a large number of items and then studying their behavior in the aggregate (52). In short, the frailty index integrates a great deal of information quantitatively, so as to get a relevant and nonarbitrary measure of the overall health status of individual animals.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Frailty Index in Aging Mice: Comparisons With Frailty Index Data in Humans

Whitehead¹,

Hildebrand

Sun³

et al. 2013

The Journals of Gerontology: Series A

Self Cite

367

423

View full text Add to dashboard Cite

We previously quantified frailty in aged mice with frailty index (FI) that used specialized equipment to measure health parameters. Here we developed a simplified, noninvasive method to quantify frailty through clinical assessment of C57BL/6J mice (5–28 months) and compared the relationship between FI scores and age in mice and humans. FIs calculated with the original performance-based eight-item FI increased from 0.06±0.01 at 5 months to 0.36±0.06 at 19 months and 0.38±0.04 at 28 months (n = 14). By contrast, the increase was graded with a 31-item clinical FI (0.02±0.005 at 5 months; 0.12±0.008 at 19 months; 0.33±0.02 at 28 months; n = 14). FI scores calculated from 70 self-report items from the first wave of the Survey of Health, Ageing and Retirement in Europe were plotted as function of age (n = 30,025 people). The exponential relationship between FI scores and age (normalized to 90% mortality) was similar in mice and humans for the clinical FI but not the eight-item FI. This noninvasive FI based on clinical measures can be used in longitudinal studies to quantify frailty in mice. Unlike the performance-based eight-item mouse FI, the clinical FI exhibits key features of the FI established for use in humans.

show abstract

“…level of frailty increases proportionally as the number of health deficits increases) [15,16]. The underlying mechanisms of deficit accumulation suggest that there is a critical threshold of agerelated decline in multiple physiological systems, beyond which deficits start to accumulate, resulting in poor health [3,17]. The FI has been validated by researchers around the world with multiple studies, applied to population-based and clinical settings alike with diverse outcomes [18][19][20][21][22][23][24].…”

Section: Frailty Assessmentmentioning

confidence: 99%

Using an Electronic Comprehensive Geriatric Assessment and Health Coaching to Prevent Frailty in Primary Care: The CARES Model

Garm¹,

Park²,

Song³

2018

Med Clin Rev

Self Cite

View full text Add to dashboard Cite

Frailty threatens the quality of life of seniors. As the leading cause for the disproportionate use of health care resources, frailty is a serious threat to the sustainability of the health care system. Mounting evidence suggests frailty can be prevented with early assessment and management. Primary care providers are well positioned to identify "at risk" seniors and enact care plans to prevent frailty from progressing. The Comprehensive Geriatric Assessment (CGA) has repeatedly demonstrated value in the clinical setting for enhanced outcomes for seniors. The Frailty Index (FI) is a reliable and sensitive measure of frailty that can be generated from the CGA (FI-CGA). Implementing the FI-CGA into the electronic medical records of primary care can enable the use of a reliable and valid measurement of frailty at point of service. Using the electronic FI-CGA in the clinic setting guides healthcare providers to make more meaningful and comprehensive healthcare decisions. Based on the degree of frailty, health coaching aims to both support the seniors competence in their self-management as well the adoption of health promoting behaviors like exercise and improved nutritional choices. The Community Actions and Resources Empowering Seniors (CARES) collaborative model in primary care aims to provide substantial healthcare cost savings over time by addressing frailty at early stages and decreasing costly hospital admissions. CARES further aims to improve the quality of life of seniors by generating a sense of empowerment and control over their risk for frailty through health coaching to adopt healthy aging strategies.

show abstract

A limit to frailty in very old, community-dwelling people: a secondary analysis of the Chinese longitudinal health and longevity study

Abstract: a limit to frailty occurred with FI = 0.7 which was not exceeded at any age or in any wave. There appears to be a demonstrable limit to the number of health problems that people can tolerate.

Cited by 84 publications

References 27 publications

Sex Differences in the Limit to Deficit Accumulation in Late Middle-Aged and Older Chinese People: Results From the Beijing Longitudinal Study of Aging

Sex Differences in the Limit to Deficit Accumulation in Late Middle-Aged and Older Chinese People: Results From the Beijing Longitudinal Study of Aging

A Clinical Frailty Index in Aging Mice: Comparisons With Frailty Index Data in Humans

Using an Electronic Comprehensive Geriatric Assessment and Health Coaching to Prevent Frailty in Primary Care: The CARES Model

Contact Info

Product

Resources

About