Frailty transitions in the San Antonio Longitudinal Study of Aging.
OBJECTIVE
To examine frailty transitions in Mexican American (MA) and European American (EA) older adults.


METHODS
Longitudinal, observational cohort study.


METHODS
Socioeconomically diverse neighborhoods in San Antonio, Texas.


METHODS
Three hundred twelve MA and 285 EA community-dwelling older adults (≥ 65) with frailty information at baseline (1992-1996) and transition information at follow-up (2000/01) in the San Antonio Longitudinal Study of Aging.


METHODS
Five frailty characteristics (weight loss, exhaustion, weakness, slowness, and low physical activity), frailty score (0-5), and overall frailty state (nonfrail = 0 characteristics, prefrail = 1 or 2, frail = ≥ 3) were assessed at baseline. Transitions (progressed, regressed, or no change) were assessed for frailty score and state. Odds ratios (ORs) of progression and regression in individual characteristics were estimated using generalized estimating equations adjusted for age, sex, ethnic group, socioeconomic status, comorbidity, diabetes, and follow-up interval.


RESULTS
Diabetes mellitus with macrovascular complications (OR = 1.84, 95% confidence interval (CI) = 1.02-3.33), fewer years of education (OR = 0.96, 95% CI = 0.93-1.0) and follow-up interval (OR = 1.3, 95% CI = 1.17-1.46) were significant predictors of progression in any frailty characteristic. Mortality increased with greater frailty state, and prefrail individuals were more likely than frail individuals to regress.


CONCLUSIONS
Diabetes mellitus with macrovascular complications and fewer years of education are important predictors of progression in any frailty characteristic. Because of greater risk of death than for the nonfrail state and greater likelihood of regression than for the frail state, the prefrail state may be an optimal target for intervention.
Department of Medicine, Division of Geriatrics, Gerontology and Palliative Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA. espinozas2@uthscsa.edu
Sara E
SE
Espinoza
Inkyung
I
Jung
Helen
H
Hazuda
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology* / Q000502:physiology; D003071:Cognition / Q000502:physiology; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D016138:Walking / Q000502:physiology; D015431:Weight Loss / Q000208:ethnology