Prevalence and Outcomes of Frailty in Older Men—the Manitoba Follow-Up Study

Abstract

Background

The Frailty Index (FI) is a measure of frailty with recent guidance on its calculation. Objectives were: 1) To determine the prevalence of frailty and its component domains at different ages in older men; and 2) To determine if the FI, and/or its component scores predict death or long-term care (LTC) admission. Design: A cohort study. Setting: Most of the participants lived in Canada. Subjects: 3,983 men who qualified for air crew training during the Second World War. We included 1,711 men (mean age 76) free of dementia, living in the community, who had data to construct a FI in 1996.

Methods

Medical conditions have been measured from 1948. Functional status, health status, and social well-being have been measured by survey since 1996. We constructed a FI from these data and calculated the prevalence of frailty from the age of 75+. We considered three domains of frailty: medical, functional, and psychosocial. We calculated the mortality risk and the risk of LTC care admission using proportional hazards models.

Results

Frailty, dementia, and LTC use are all strongly related to age. The FI is associated with mortality and LTC admission at all ages. This effect was a spectrum of risk. The effect of functional domains was seen at all ages, while the effect of medical conditions on these outcomes declined with advancing age. Psychosocial domains were less strongly correlated with these outcomes.

Conclusions

The FI is associated with adverse outcomes, and should be considered in clinical and policy decisions.