National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Department of Probability and Statistics, IIMAS, Universidad Nacional Autónoma de México, Mexico City, Mexico.
J Gerontol A Biol Sci Med Sci. 2024 Apr 1;79(4). doi: 10.1093/gerona/glae068.
Frailty is a dynamic state in older adults. Current evidence, mostly in high-income countries, found that improving frailty is more likely in mild states (prefrailty). We aimed to determine the probability of frailty transitions and their predictors.
Participants were adults aged 50 years or over from the Study on Global Ageing and Adult Health in Mexico during 4 waves (2009, 2014, 2017, and 2021). We defined frailty with the frailty phenotype and we used multinomial logistic models to estimate the probabilities of frailty transitions and determine their predictors.
For the 3 analyzed periods (2009-2014, 2014-2017, and 2017-2021), transition probabilities from frail to robust were higher for the younger age group (50-59 years) at 0.20, 0.26, and 0.20, and lower for the older age group (≥80 years), 0.03, 0.08 and 0.04. Transitioning from prefrail to robust had probabilities of 0.38, 0.37, and 0.35, for the younger age group, and 0.09, 0.18, and 0.10, for the older age group. The probabilities of transitioning to frail and to death were lower for the younger age group and for the robust at baseline; but higher for the older age group and for the frail at baseline. We identified age, disability, and diabetes as the most significant predictors of frailty transitions.
These findings show that frailty has a dynamic nature and that a significant proportion of prefrail and frail individuals can recover to a robust or prefrail state. They also emphasize that prefrailty should be the focus of interventions.
衰弱是老年人的一种动态状态。目前的证据主要来自高收入国家,发现改善衰弱状态在轻度状态(衰弱前期)更为可能。我们旨在确定衰弱状态的转变及其预测因素的概率。
参与者为来自墨西哥的全球老龄化和成人健康研究中的 50 岁及以上成年人,在 4 个波次(2009 年、2014 年、2017 年和 2021 年)进行了研究。我们使用衰弱表型来定义衰弱,使用多变量逻辑模型来估计衰弱状态转变的概率,并确定其预测因素。
在分析的 3 个时期(2009-2014 年、2014-2017 年和 2017-2021 年)中,年轻年龄组(50-59 岁)从虚弱到健壮的转变概率更高,分别为 0.20、0.26 和 0.20,而年龄较大的年龄组(≥80 岁)则较低,分别为 0.03、0.08 和 0.04。从衰弱前期到健壮的转变概率分别为年轻年龄组的 0.38、0.37 和 0.35,年龄较大的年龄组为 0.09、0.18 和 0.10。年轻年龄组和健壮的基线的向衰弱和死亡转变的概率较低,而年龄较大的年龄组和衰弱的基线的向衰弱和死亡转变的概率较高。我们确定年龄、残疾和糖尿病是衰弱状态转变的最显著预测因素。
这些发现表明衰弱具有动态性,相当一部分衰弱前期和衰弱个体可以恢复到健壮或衰弱前期状态。它们还强调衰弱前期应该是干预的重点。