Frailty index and gender‐specific mortality in Korean adults: Findings from the Korean Longitudinal Study of Aging (2006–2018)

Abstract

Aims To examine the predictive ability of the frailty index in estimating gender‐specific mortality in a population of Korean adults. Design A descriptive and prospective longitudinal design. Methods Data were used from the Korean Longitudinal Study of Aging conducted from 2006 through 2018. A total of 10,254 adults aged 45–98 years at baseline were included. A 41‐item deficit accumulation frailty index was measured, based on multi‐domain assessment such as self‐rating of health, physical condition, mental status, cognitive function, activities of daily living, instrumental activities of daily living and chronic conditions. We categorized the frailty index into robust (≤0.10), prefrail (0.10–0.25) and frail (≥0.25). Cox's proportional hazards regression analysis was employed to determine the association between the frailty index and all‐cause mortality. Results A total of 4705 individuals (45.9%) were categorized as robust, 4178 (40.7%) as prefrail and 1371 (13.4%) as frail. The frailty index increased with age, and females were found to have a higher frailty index than males. The survival probabilities were significantly lower in older adults (aged ≥65) compared with adults and significantly lower in males compared with females. Compared with the robust group, the risk of mortality in the prefrail and frail groups was 1.37 and 2.57 times higher, respectively. The association between frailty status and all‐cause mortality was similar in adults and older adults, while the hazard ratios were higher in frail group of males than that of females. Conclusion The frailty index had a predictive ability for all‐cause mortality with respect to age and sex. Impact Using a frailty index among community‐dwelling adults could be beneficial to support healthcare providers in early detection of individuals with frailty and facilitate the development of more effective interventions for reducing mortality.

Impact of preoperative laboratory frailty index on mortality and clinical outcomes in older surgical patients with cancer

“…Frail female have a higher risk of readmission and lower survival rate than frail male 43 . However, a recent study estimating sex-specific mortality using frailty index in a population of Korean adults, it was reported that although female had a higher frailty index than male, the survival probability was significantly lower in male than in female 44 . Perhaps this association suggests that characteristics of biological, behavioral, and social sex may affect biological health outcomes.…”

“…In addition, extensive evidence shows the importance of sex differences in frailty 42 – 44 . Female are known to have a higher degree of frailty than male at all ages 43 .…”

Association of low muscle mass and obesity with increased all‐cause and cardiovascular disease mortality in US adults

“…On the one hand, the frailty phenotype specifies frailty as poor performance in three out of the following five criteria: weight loss, exhaustion, weakness, slowness and a lack of activity. On the other hand, the frailty index is a ratio of the number of deficits accumulated by an individual divided by all deficits measured 10,11 . Sarcopenia and frailty overlap, particularly with respect to the physical aspects of the frailty phenotype, such as low grip strength, gait speed, and muscle mass 12 …”