Frailty and type of death among older adults in China: prospective cohort study.
OBJECTIVE
To examine the association between frailty and type of death among the world's largest oldest-old population in China.


METHODS
Prospective cohort study.


METHODS
2002 and 2005 waves of the Chinese longitudinal healthy longevity survey carried out in 22 provinces throughout China.


METHODS
13 717 older adults (aged >or=65).


METHODS
Type of death, categorised as being bedridden for fewer than 30 days with or without suffering and being bedridden for 30 or more days with or without suffering.


RESULTS
Multinomial analyses showed that higher levels of frailty significantly increased the relative risk ratios of mortality for all types of death. Of those with the highest levels of frailty, men were most likely to experience 30 or more bedridden days with suffering before death (relative risk ratio 8.70, 95% confidence interval 6.31 to 12.00) and women 30 or more bedridden days with no suffering (11.53, 17.84 to 16.96). Regardless of frailty, centenarians and nonagenarians were most likely to experience fewer than 30 bedridden days with no suffering, whereas those aged 65-79 and 80-89 were more likely to experience fewer than 30 bedridden days with suffering. Adjusting for compositional differences had little impact on the link between frailty and type of death for both sexes and age groups.


CONCLUSIONS
The association between frailty and type of death differs by sex and age. Health scholars and clinical practitioners should consider age and sex differences in frailty to develop more effective measures to reduce preventable suffering before death.
Department of Sociology and Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC 27710, USA. med11@geri.duke.edu
Matthew E
ME
Dupre
Danan
D
Gu
David F
DF
Warner
Zeng
Z
Yi
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D008136:Longevity; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D012307:Risk Factors