title: Frailty and Mortality Outcomes in Cognitively Normal Older People: Sex Differences in a Population-Based Study.
abstract: OBJECTIVE
  To characterize frailty in cognitively normal older adults at baseline and to investigate the relationship between frailty and mortality.
  
  
  METHODS
  Population-based prospective cohort study: Mayo Clinic Study of Aging.
  
  
  METHODS
  Olmsted County, Minnesota.
  
  
  METHODS
  Cognitively normal older persons aged 70 and older (mean age 78.8±5.2, 50.2% male; N=2,356).
  
  
  METHODS
  Frailty was assessed at baseline using a 36-item Frailty Index. Four frailty subgroups were identified based on the Frailty Index (≤0.10 (fit), 0.11-0.20 (at risk), 0.21-0.30 (frail), >0.30 (frailest)). All participants underwent comprehensive clinical and cognitive assessments. The association between frailty and mortality was assessed using Cox proportional hazards models.
  
  
  RESULTS
  The median Frailty Index was 0.17 (interquartile range 0.11-0.22). Frailty increased with age and was more common in older men than in older women. Over a median follow-up of 6.5 years (range 7 days to 8.9 years), 500 of the 2,356 participants died, including 292 men. The frailest participants had the greatest risk of death (hazard ratio (HR)=3.91, 95% confidence interval (CI)=2.69-5.68). The association was stronger in women (HR=5.26, 95% CI=2.88-9.61) than men (HR=3.15, 95% CI=1.98-5.02).
  
  
  CONCLUSIONS
  Baseline frailty was common, especially in older men, and increased with age. Frailty was associated with significantly greater risk of death, particularly in women. These sex differences should be considered when designing a geriatric care plan.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Mairead M
authors.initials: MM
authors.lastname: Bartley
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.|Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, Arizona.|Department of Neurology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Yonas E
authors.initials: YE
authors.lastname: Geda
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Teresa J H
authors.initials: TJ
authors.lastname: Christianson
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: V Shane
authors.initials: VS
authors.lastname: Pankratz
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.|Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rosebud O
authors.initials: RO
authors.lastname: Roberts
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.|Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003071:Cognition / Q000502:physiology*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends
keywords: Frailty Index; aging; frailty; mortality; sex differences