title: Frailty Trajectories in an Elderly Population-Based Cohort.
abstract: OBJECTIVE
  To identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an aging population and to estimate associations between frailty trajectories and emergency department visits, hospitalizations, and all-cause mortality.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Olmsted County, Minnesota.
  
  
  METHODS
  Olmsted County, Minnesota residents aged 60-89 in 2005.
  
  
  METHODS
  Longitudinal changes in frailty between 2005 and 2012 were measured by constructing a yearly Rockwood frailty index incorporating body mass index, 17 comorbidities, and 14 activities of daily living. The frailty index measures variation in health status as the proportion of deficits present of the 32 considered (range 0-1).
  
  
  RESULTS
  Of the 16,443 Olmsted County residents aged 60-89 in 2005, 12,270 (74.6%) had at least 3 years of frailty index measures and were retained for analysis. The median baseline frailty index increased with age (0.11 for 60-69, 0.14 for 70-79, 0.19 for 80-89). Three distinct frailty trajectories were identified in individuals aged 60-69 at baseline and two trajectories in those aged 70-79 and 80-89. Within each decade of age, increasing frailty trajectories were associated with greater risks of emergency department visits, hospitalization, and all-cause mortality, even after adjustment for baseline frailty index.
  
  
  CONCLUSIONS
  The number of frailty trajectories differed according to age. Within each age group, those in the highest frailty trajectory had greater healthcare use and worse survival. Frailty trajectories may offer a way to target aging individuals at high risk of hospitalization or death for therapeutic or preventive interventions.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lila J
authors.initials: LJ
authors.lastname: Finney Rutten
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Manemann
authors.affiliation: Department of Research, Olmsted Medical Center, Rochester, Minnesota.
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Jacobson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Chun
authors.initials: C
authors.lastname: Fan
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
authors.forename: Brandon R
authors.initials: BR
authors.lastname: Grossardt
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.|Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009026:Mortality / Q000639:trends*; D018570:Risk Assessment
keywords: aging; frailty; longitudinal studies; population research