Frailty in older men: prevalence, progression, and relationship with mortality.
OBJECTIVE
To describe the association between frailty and health status, the progression of frailty, and the relationship between frailty and mortality in older men.


METHODS
Cross-sectional and prospective cohort study.


METHODS
Six U.S. clinical centers.


METHODS
Five thousand nine hundred ninety-three community-dwelling men aged 65 and older.


METHODS
Frailty was defined as three or more of the following: sarcopenia (low appendicular skeletal mass adjusted for height and body fat), weakness (grip strength), self-reported exhaustion, low activity level, and slow walking speed. Prefrail men met one or two criteria; robust men had none. Follow-up averaged 4.7 years.


RESULTS
At baseline, 240 subjects (4.0%) were frail, 2,395 (40.0%) were prefrail, and 3,358 were robust (56.0%). Frail men were less healthy in most measures of self-reported health than prefrail or robust men. Frailty was somewhat more common in African Americans (6.6%) and Asians (5.8%) than Caucasians (3.8%). At the second visit, men who were frail at baseline tended to remain frail (24.2%) or die (37.1%) or were unable to complete the follow-up visit (26.2%); robust men tended to remain robust (54.4%). Frail men were approximately twice as likely to die as robust men (multivariate hazard ratio (MHR)=2.05, 95% confidence interval (CI)=1.55-2.72). Mortality risk for frail men was greater in all weight categories than for nonfrail men but was highest for normal-weight frail men (MHR=2.39, 95% CI=1.51-3.79, P for interaction=.01). The relationship between frailty and mortality was somewhat stronger in younger men than older men (P for interaction=.01).


CONCLUSIONS
Frailty in older men is associated with poorer health and a greater risk of mortality.
Cawthon
Peggy M
PM
Research Institute, California Pacific Medical Center, San Francisco, California 94107-1762, USA. pcawthon@sfcc-cpmc.net
Marshall
Lynn M
LM
Michael
Yvonne
Y
Dam
Thuy-Tien
TT
Ensrud
Kristine E
KE
Barrett-Connor
Elizabeth
E
Orwoll
Eric S
ES
D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D015995:Prevalence