title: Frailty predicts trajectories of quality of life over time among British community-dwelling older people.
abstract: To investigate associations between baseline frailty status and subsequent changes in QOL over time among community-dwelling older people.
  
  
  
  Among 363 community-dwelling older people ≥65 years, frailty was measured using Frailty Index (FI) constructed from 40 deficits at baseline. QOL was measured using Older People's Quality of Life Questionnaire (OPQOL) six times over 2.5 years. Two-level hierarchical linear models were employed to predict QOL changes over time according to baseline frailty.
  
  
  
  At baseline, mean age was 73.1 (range 65-90) and 62.0 % were women. Mean FI was 0.17 (range 0.00-0.66), and mean OPQOL was 130.80 (range 93-163). The hierarchical linear model adjusted for age, gender, ethnicity, education, and enrollment site predicted that those with higher FI at baseline have lower QOL than those with lower FI (regression coefficient = -47.64, p < 0.0001) and that QOL changes linearly over time with slopes ranging from 0.80 (FI = 0.00) to -1.15 (FI = 0.66) as the FI increases. A FI of 0.27 is the cutoff point at which improvements in QOL over time change to declines in QOL.
  
  
  
  Frailty was associated with lower QOL among British community-dwelling older people. While less frail participants had higher QOL at baseline and QOL improved over time, QOL of frailer participants was lower at baseline and declined.
authors.affiliation: Department of Primary Care and Population Health, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK. gotarokojima@yahoo.co.jp.
authors.forename: Gotaro
authors.initials: G
authors.lastname: Kojima
authors.affiliation: Department of Primary Care and Population Health, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Morris
authors.affiliation: Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.affiliation: School of Health and Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Dawn A
authors.initials: DA
authors.lastname: Skelton
authors.affiliation: Department of Health Care for Older People, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Ann
authors.initials: A
authors.lastname: Bowling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011788:Quality of Life; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Community-dwelling older people; Frailty; Quality of life; Well-being