title: The association of race with frailty: the cardiovascular health study.
abstract: OBJECTIVE
  Frailty, which has been conceptualized as a state of decreased physiologic reserve contributing to functional decline, has a prevalence among older African Americans that is twice that in older whites. This study assesses the independent contribution of race to frailty.
  
  
  METHODS
  We evaluated 786 African-American and 4491 white participants of the Cardiovascular Health Study (CHS). Frailty is defined as meeting three or more of five criteria derived from CHS measures: lowest quintile for grip strength, self-reported exhaustion, unintentional weight loss of 10 lbs or greater in 1 year, slowest quintile for gait speed, and lowest quintile for physical activity. Controlling for age, sex, comorbidity, socioeconomic factors, and race, multinomial logistic regression estimated the odds ratio (OR) of prefrail (one or two criteria) to not frail and frail to not frail.
  
  
  RESULTS
  Among African Americans, 8.7% of men and 15.0% of women were frail compared with 4.6% and 6.8% of white men and women, respectively. In adjusted models, nonobese African Americans had a fourfold greater odds of frailty compared with whites. The increased OR of frailty associated with African-American race was less pronounced among those who were obese or disabled.
  
  
  CONCLUSIONS
  African-American race is associated independently with frailty.
authors.affiliation: Division of General Medicine, University of California, Davis Medical Center, Sacramento, CA 95817, USA. chhirsch@ucdavis.edu
authors.forename: Calvin
authors.initials: C
authors.lastname: Hirsch
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
authors.forename: Willem
authors.initials: W
authors.lastname: Kop
authors.forename: Sharon
authors.initials: S
authors.lastname: Jackson
authors.forename: John
authors.initials: J
authors.lastname: Gottdiener
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D001741:Black or African American; D000368:Aged; D001247:Asthenia; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D016017:Odds Ratio; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D044465:White People