title: Understanding Risk in the Oldest Old: Frailty and the Metabolic Syndrome in a Chinese Community Sample Aged 90+ Years.
abstract: OBJECTIVE
  To investigate the relationship between frailty and the metabolic syndrome and to evaluate how these contribute to mortality in very old people.
  
  
  METHODS
  Secondary analysis of data from the Project of Longevity and Aging in Dujiangyan.
  
  
  METHODS
  Community sample from Sichuan Province, China.
  
  
  METHODS
  People aged 90+ years (n=767; baseline age=93.7±3.4 years; 68.0% women.
  
  
  METHODS
  After a baseline health assessment, participants were followed for four years (54.0% died). A frailty index (FI) was calculated as the sum of deficits present, divided by the 35 health-related deficits considered. Relationships between the FI and the metabolic syndrome were tested; their effect on death was examined.
  
  
  RESULTS
  The mean FI was 0.26 ±0.11. Higher FI scores were associated with a greater risk of death, adjusted for age, sex, education, and metabolic syndrome items. The hazard ratio was 1.03 (95% confidence interval 1.02, 1.04) for each 1% percent increase of the FI. The mortality risk did not change with the metabolic syndrome (odds ratio=0.99; 0.71-1.36).
  
  
  CONCLUSIONS
  In the oldest old, frailty was a significant risk for near-term death, regardless of the metabolic syndrome. Even using age-adjusted models, the epidemiology of late life illness may need to account for frailty routinely.
authors.affiliation: Kenneth Rockwood, Division of Geriatric Medicine, Dalhousie University, Suite 1421-5955 Veterans Memorial Lane, Halifax, Nova Scotia, B3H 2E1, Canada, Tel: 1-902-473-8631; Fax: 1-902-473-1050, kenneth.rockwood@dal.ca.
authors.forename: Q
authors.initials: Q
authors.lastname: Hao
authors.forename: X
authors.initials: X
authors.lastname: Song
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.forename: B
authors.initials: B
authors.lastname: Dong
authors.forename: K
authors.initials: K
authors.lastname: Rockwood
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D044466:Asian People; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome; D016016:Proportional Hazards Models; D012307:Risk Factors