ArticleEuropean journal of epidemiology2014
Frailty prevalence and 10-year survival in community-dwelling older adults: results from the ESTHER cohort study.
Article in European journal of epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 2 of them syntheses that pooled it.
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Who cites it
60 citing papers in PubMed, 2 syntheses or guidelines pooled it, 126 citations in OpenAlex.
- Prevalence of Prefrailty and Frailty Among Older Adults in Germany: A Systematic Review, Meta-Analysis and Meta-Regression.Frontiers in medicine · 2022Pooled it
- Relationship between frailty and mortality, hospitalization, and cardiovascular diseases in diabetes: a systematic review and meta-analysis.Cardiovascular diabetology · 2019Pooled it
- A 90 g/day low-carbohydrate diet improved glycemic control without decreasing frailty in older patients with type 2 diabetes: A secondary analysis of a randomized controlled trial.Journal of diabetes investigation · 2025Trial
- Validation of a Deficit-Accumulation Frailty Index in the ASPirin in Reducing Events in the Elderly Study and Its Predictive Capacity for Disability-Free Survival.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Trial
- Frailty among older adults in Germany: regional variation across NAKO study centers.International journal for equity in health · 2026Article
- Growth differentiation factor 15 predicts physical function impairment in Spanish older adults: a real-world prospective study.GeroScience · 2026Article
- Development of Age- and Sex-Specific Metabolomics-Based Biological Ageing Clocks for 10-Year Mortality Prediction.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Inflammaging and the sex-frailty paradox.Aging clinical and experimental research · 2025Article
- Applying a life course approach to elucidate the biology of sex differences in frailty: early-life gonadectomy diminishes late-life robustness in male and female dogs in the Exceptional Aging in Rottweilers Study.Biology of sex differences · 2025Article
- Analysis of the Correlation between Frailty Index, Clinical Characteristics, Use of Anti-Epileptic Drug, and Prognosis in Elderly Patients with Epilepsy.Actas espanolas de psiquiatria · 2025Article
- Patient Priorities Care Increases Long-Term Service and Support Use: Propensity Match Cohort Study.Journal of the American Medical Directors Association · 2024Article
- Article
- Dietary Sodium Restriction and Frailty among Middle-Aged and Older Adults: An 8-Year Longitudinal Study.Nutrients · 2024Article
- Poor Nutritional Status Is Associated with Death in a Population of Dialyzed Older Persons.The Journal of frailty & aging · 2024Article
- Patients with low ALT levels are at increased risk for severe COVID-19.Frontiers in medicine · 2023Article
- Association of longitudinal repeated measurements of frailty index with mortality: Cohort study among community-dwelling older adults.EClinicalMedicine · 2022Article
- Beneficial Effect of HInternational journal of molecular sciences · 2022Article
- Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome.Journal of clinical medicine · 2022Article
- Out-of-pocket expenses related to aging in place for frail older people: a scoping review.JBI evidence synthesis · 2022Article
- The influence of frailty syndrome on quality of life in elderly patients with type 2 diabetes.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The frailty index (FI), defined by a deficit accumulation approach, has emerged as a promising concept in gerontological research, but applications have been mostly restricted to populations from Canada and the United States aged 65 years or older. Baseline data from the German ESTHER cohort study (N 9,886; age 50-75; mean follow-up 8.7 years) were used to create a FI through a deficit accumulation approach. For estimation of frailty prevalence, we used cut-points for the FI to define three categories (non-frail 0 to ≤0.20; pre-frail >0.20 to <0.45; frail ≥0.45). We assessed variation of the FI by age and sex: 10-year survival according to baseline FI was assessed by Kaplan-Meier curves and bivariate and multivariate Cox proportional hazard models. Cubic splines were used to assess sex-specific dose-response associations. Prevalence of frailty was 9.2 and 10.5% in women and men, respectively. Age-specific prevalence of frailty ranged from 4.6% in 50-54 year old participants to 17.0% in 70-75 year old participants. Below 60 years of age, men had a higher FI than women. However, the FI showed a stronger increase with age among women (3.1% per year) than among men (1.7% per year) and was higher among women than men in older age groups. Adjusted hazard ratios (95% confidence intervals) for all-cause mortality were 1.08 (0.84-1.39), 1.32 (1.05-1.66), 1.77 (1.41-2.22), and 2.60 (2.11-3.20) for the 2nd, 3rd, 4th, and 5th quintile of the FI compared to 1st quintile, respectively. There was a strong dose-response relationship between the FI and total mortality among both men and women and both younger (<65 years) and older subjects. We found sex differences in the FI and its increase with age, along with a consistent strong association of the FI with mortality in both sexes, even for age group 50-64.
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