Static and dynamic measures of frailty predicted decline in performance-based and self-reported physical functioning.
OBJECTIVE
To determine the effect of frailty on decline in physical functioning and to examine if chronic diseases modify this effect.


METHODS
The study sample was derived from the Longitudinal Aging Study Amsterdam and included respondents with initial ages 65 and over at T(2) (1995/1996), who participated at T(1) (1992/1993) and T(2) and performed physical performance tests (n = 1,152) or reported functional limitations (n = 1,321) at T(2) and T(3) (1998/1999). Nine frailty markers were determined in two ways: low functioning at T(2) (static definition); and decline in functioning between T(1) and T(2) (dynamic definition). Using logistic regression analyses, the effect of frailty was examined on change in physical functioning between T(2) and T(3), adjusting for sex, age, education, and additionally chronic diseases.


RESULTS
Static frailty was associated with performance decline only in the middle-old group (OR 2.43; 95%CI 1.23-4.80) and associated with decline in self-reported functioning (OR 2.44; 95%CI 1.77-3.36). Dynamic frailty was associated with decline in performance only in women (OR 1.72; 95%CI 1.11-2.67) and with self-reported functional decline (OR 1.77; 95%CI 1.29-2.43). These associations were independent of chronic diseases.


CONCLUSIONS
Frailty is more strongly associated with self-reported functional decline in older persons than with performance decline.
Puts
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MT
LASA, Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam Amsterdam, The Netherlands. m.puts@vumc.nl
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D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D010809:Physical Fitness; D004856:Postural Balance; D011788:Quality of Life; D012647:Self-Assessment