title: Frailty in Older Adults: A Nationally Representative Profile in the United States.
abstract: BACKGROUND
  Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people.
  
  
  METHODS
  A popular, validated frailty phenotype proposed by Fried and colleagues was applied to 7,439 participants in the 2011 baseline of the National Health and Aging Trends Study, a national longitudinal study of persons aged 65 and older. All measures drew on a 2-hour in-person interview. Weighted estimates of frailty prevalence were obtained.
  
  
  RESULTS
  Fifteen percent (95% CI: 14%, 16%) of the older non-nursing home population is frail, and 45% is prefrail (95% CI: 44%, 47%). Frailty is more prevalent at older ages, among women, racial and ethnic minorities, those in supportive residential settings, and persons of lower income. Independently of these characteristics, frailty prevalence varies substantially across geographic regions. Chronic disease and disability prevalence increase steeply with frailty. Among the frail, 42% were hospitalized in the previous year, compared to 22% of the prefrail and 11% of persons considered robust. Hip, back, and heart surgery in the last year were associated with frailty. Over half of frail persons had a fall in the previous year.
  
  
  CONCLUSIONS
  Our findings support the importance of frailty in late-life health etiology and potential value of frailty as a marker of risk for adverse health outcomes and as a means of identifying opportunities for intervention in clinical practice and public health policy.
authors: Department of Biostatistics, Bloomberg School of Public Health and Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. kbandeen@jhu.edu.
authors: Karen
authors: K
authors: Bandeen-Roche
authors: Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors: Christopher L
authors: CL
authors: Seplaki
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Jin
authors: J
authors: Huang
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Brian
authors: B
authors: Buta
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Rita R
authors: RR
authors: Kalyani
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Ravi
authors: R
authors: Varadhan
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Qian-Li
authors: QL
authors: Xue
authors: Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland. Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Jeremy D
authors: JD
authors: Walston
authors: Department of Health Policy and Management, Bloomberg School of Public Health, Baltimore, Maryland.
authors: Judith D
authors: JD
authors: Kasper
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D015995:Prevalence; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Epidemiology; Health disparities; Public health