title: Long-term mortality in frail elderly subjects with osteoarthritis.
abstract: OBJECTIVE
  Elderly subjects are characterized by a high prevalence of OA and clinical frailty. This study aimed to examine the predictive role of clinical frailty on long-term mortality in elderly subjects with and without OA.
  
  
  METHODS
  Mortality was evaluated after a 12-year follow-up in 698 subjects with and 590 subjects without OA recruited in 1992. Clinical frailty was assessed according to the Frailty Staging System and stratified in tertiles.
  
  
  RESULTS
  After a 12-year follow-up, mortality was 42.2% in subjects without and 55.8% in subjects with OA (P = 0.256). With increasing frailty, mortality increased by 30.5% (P for trend < 0.001) in subjects without and by 45.6% in subjects with OA (P for trend < 0.001). Multivariate analysis showed that frailty [hazard ratio (HR) = 1.49 for each unit of increase, 95% CI 1.32, 1.94, P < 0.001) but not OA (HR = 1.28, 95% CI 0.987, 1.39, P = 0.412) was predictive of long-term mortality. Moreover, when Cox regression analysis was performed, frailty enhanced the risk of long-term mortality for each unit of increase by 32% (HR = 1.32, 95% CI 1.06, 1.65, P = 0.03) in the absence of OA and by 98% in the presence (HR = 1.98, 95% CI 1.63, 2.95, P < 0.01) of OA.
  
  
  CONCLUSIONS
  Clinical frailty significantly predicts mortality in subjects without OA and even more in those with OA. Thus clinical frailty may be considered a new prognostic factor to identify subjects with OA at high risk of mortality.
authors.affiliation: Dipartimento di Scienze Mediche Traslazionali, University of Naples Federico II, 80131 Napoli, Italy. p.abete@unina.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cacciatore
authors.forename: David
authors.initials: D
authors.lastname: Della-Morte
authors.forename: Claudia
authors.initials: C
authors.lastname: Basile
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazzella
authors.forename: Chiara
authors.initials: C
authors.lastname: Mastrobuoni
authors.forename: Elisa
authors.initials: E
authors.lastname: Salsano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Galizia
authors.forename: Franco
authors.initials: F
authors.lastname: Rengo
authors.forename: Domenico
authors.initials: D
authors.lastname: Bonaduce
authors.forename: Pasquale
authors.initials: P
authors.lastname: Abete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D010003:Osteoarthritis / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis; D012307:Risk Factors
keywords: elderly; frailty; mortality; osteoarthritis