title: Social and behavioural factors associated with frailty trajectories in a population-based cohort of older adults.
abstract: The goal of this study was to identify distinct frailty trajectories (clusters of individuals following a similar progression of frailty over time) in an ageing population and to determine social and behavioural factors associated with frailty trajectories.
  
  
  
  Population-based cohort study.
  
  
  
  Olmsted County, Minnesota.
  
  
  
  Olmsted County, Minnesota residents aged 60-89 in 2005.
  
  
  
  Changes in frailty over an 8-year period from 2005 to 2012, measured by constructing a yearly frailty index. Frailty trajectories by decade of age were determined using k-means cluster modelling for longitudinal data.
  
  
  
  After adjustment for age and sex, all social and behavioural factors (education, marital status, living arrangements, smoking status and alcohol use) were significantly associated with frailty trajectories in those aged 60-69 and 70-79 years. After further adjustment for baseline frailty, the likelihood of being in the high frailty trajectory was greatest among those reporting concerns from relatives/friends about alcohol consumption (OR (95% CI) 2.26 (1.19 to 4.29)) and those with less than a high school education (OR (95% CI) 1.98 (1.32 to 2.96)) in the 60-69 year olds. In the 70-79 year olds, the largest associations were observed among those with concerns from oneself about alcohol consumption (OR (95% CI) 1.92 (1.23 to 3.00)), those with less than a high school education (OR (95% CI) 1.57 (1.12 to 2.22)), and those living with family (vs spouse; OR (95% CI) 1.76 (1.05 to 2.94)). No factors remained associated with frailty trajectories in the 80-89 year olds after adjustment for baseline frailty.
  
  
  
  Social and behavioural factors are associated with frailty, with stronger associations observed in younger ages. Recognition of social and behavioural factors associated with increasing frailty may inform interventions for individuals at risk of worsening frailty, specifically when targeted at younger individuals.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Chamberlain
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Debra J
authors.initials: DJ
authors.lastname: Jacobson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Manemann
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Chun
authors.initials: C
authors.lastname: Fan
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
authors.affiliation: Department of Research, Olmsted Medical Center, Rochester, Minnesota, USA.
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Lila J
authors.initials: LJ
authors.lastname: Finney Rutten
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D000073496:Frailty / Q000453:epidemiology*; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011379:Prognosis; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: aging; frailty; population research; social factors