Association of entirely claims-based frailty indices with long-term outcomes in patients with acute myocardial infarction, heart failure, or pneumonia: a nationwide cohort study in Turkey

Kundi, Harun; Coşkun, Nazım; Yeşiltepe, Metin

doi:10.1016/j.lanepe.2021.100183

Cited by 10 publications

(11 citation statements)

References 30 publications

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“…Two principal instruments were widely accepted in clinical practice 12 , the performance and questionnaire-based approach suggested by Fried et al 4 and the "Frailty index (FI)-approach" suggested by Rockwood et al 10 , which can use any kind of data as long as the included items are frailty-related and fulfill specific validated criteria. FI has been shown to be a valid predictor of morbidity and mortality in many different population-based cohorts 13,14 .Epigenetic modifications have been recognized to play a major role in aging 15,16 and aging-related conditions, such as frailty 17,18 .…”

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confidence: 99%

Derivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults

Delerue

Schöttker

et al. 2022

Nat Commun

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DNA methylation (DNAm) patterns in peripheral blood have been shown to be associated with aging related health outcomes. We perform an epigenome-wide screening to identify CpGs related to frailty, defined by a frailty index (FI), in a large population-based cohort of older adults from Germany, the ESTHER study. Sixty-five CpGs are identified as frailty related methylation loci. Using LASSO regression, 20 CpGs are selected to derive a DNAm based algorithm for predicting frailty, the epigenetic frailty risk score (eFRS). The eFRS exhibits strong associations with frailty at baseline and after up to five-years of follow-up independently of established frailty risk factors. These associations are confirmed in another independent population-based cohort study, the KORA-Age study, conducted in older adults. In conclusion, we identify 65 CpGs as frailty-related loci, of which 20 CpGs are used to calculate the eFRS with predictive performance for frailty over long-term follow-up.

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confidence: 99%

Derivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults

Delerue

Schöttker

et al. 2022

Nat Commun

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“…Moreover, another JAGES study found that the risk scoring model using age, sex, KCL items, and health check‐up data could predict dementia risk well in the older Japanese population 22 . Similarly, a significant association between frailty and risk of pneumonia was found in two prospective cohort studies from the USA 36 and Turkey 37 . The mechanisms for dementia in relation to frailty have not been clarified yet; however, there are common underlying mechanisms, including vascular dysregulation, inflammation, insulin resistance, and obesity 39 .…”

Section: Discussionmentioning

confidence: 87%

“…Frailty is associated with a poor immune system causing a failure to sufficiently respond to acute inflammation 34,35 . Frailty could increase susceptibility and mortality from pneumonia 21,36,37 . A previous JAGES study found that the existence of pre‐frailty and frailty was associated with a higher risk of pneumonia in older people [HR and 95% CI: 1.30 (1.14–1.48) and 1.92 (1.66–2.22) for pre‐frailty and frailty, respectively] 21 .…”

Section: Discussionmentioning

confidence: 99%

Pneumonia and subsequent risk of dementia: Evidence from the Japan Gerontological evaluation study

Khairan

Shirai

Shobugawa

et al. 2022

Int J Geriat Psychiatry

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Background Recently, several studies reported that pneumonia might increase the risk of cognitive decline and dementia due to increased frailty. Objectives This study aims to examine the association between a history of pneumonia and subsequent dementia risk. Methods Participants were 9952 aged 65 years or older Japanese men and women from the Japan Gerontological Evaluation Study prospective cohort study, followed up from 2013 to 2019. Dementia was identified by public long‐term care insurance registration. A history of pneumonia contracted 1 year before the baseline questionnaire in 2013. A cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia risk, adjusted for potential confounding variables. We conducted competing risk analyses using a cause‐specific hazard model. Results During the follow‐up period of 6 years, 939 persons developed dementia. There was no association between having a prior history of pneumonia with dementia risk (HR 1.20, 95% CI:0.81–1.78). However, we observed an increased risk of dementia in persons with pre‐frailty and frailty; the multivariable HR (95% CI) was 1.75 (1.48–2.07) and 2.42 (2.00–2.93) for pre‐frailty and frailty, respectively. When pneumonia and frailty were combined, the risk of dementia was the highest for the persons with a history of pneumonia and frailty; the multivariable HR (95% CI) was 2.30 (1.47–3.62). The multivariable HR (95% CI) for those without pneumonia with frailty was 1.95 (1.66–2.28). Meanwhile, the multivariable HR (95% CI) for those with pneumonia without frailty was 1.64 (0.68–3.99). Conclusion Our findings imply that a prior history of pre‐frailty and frailty with or without pneumonia, but not a history of pneumonia per se, was associated with an increased risk of dementia among population‐based‐cohort of older Japanese people.

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“…Pizzonia et al found an association between frailty and long-term mortality (median follow-up 2.4 years) in hip fracture patients, 8 however, it is unclear if this can be extrapolated to all trauma patients. In other populations frailty has been associated with all-cause mortality at 3-, 9 5- 10 and 10-years. 11 However, these findings were based on either community data, 10,11 or patients admitted with acute medical conditions.…”

Section: Introductionmentioning

confidence: 99%

“…11 However, these findings were based on either community data, 10,11 or patients admitted with acute medical conditions. 9 In addition, these retrospective studies utilised electronic data to derive frailty indices, which may be less sensitive and specific than a prospective clinical frailty assessment in predicting long-term mortality.…”

Section: Introductionmentioning

confidence: 99%

A long-term prospective cohort study of seriously injured older trauma patients

Ibitoye

Bridgeman-Rutledge

Carter

et al. 2022

Preprint

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A protocol for a prospective observational cohort study to investigate the effect of frailty on long-term outcomes in older adults admitted with trauma. Patients aged 65 years and older admitted to the Severn Major Trauma Centre at North Bristol NHS Trust in England between November 2018 and September 2019, will be followed up at 4-years. The objective is to determine if there is an association between Clinical Frailty Scale and mortality at 4 years after admission to hospital with a traumatic injury. The primary outcome will be mortality as measured by time from hospital admission to death. Analyses will be adjusted for other factors shown to be associated with mortality, using a mixed-effects multivariable Cox proportional hazards model.

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Association of entirely claims-based frailty indices with long-term outcomes in patients with acute myocardial infarction, heart failure, or pneumonia: a nationwide cohort study in Turkey

Cited by 10 publications

References 30 publications

Derivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults

Derivation and validation of an epigenetic frailty risk score in population-based cohorts of older adults

Pneumonia and subsequent risk of dementia: Evidence from the Japan Gerontological evaluation study

A long-term prospective cohort study of seriously injured older trauma patients

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