Evidence map›Paper›PMID 29684237›Full record

ArticleJournal of the American Geriatrics Society2018

Frailty Phenotype and Healthcare Costs and Utilization in Older Women.

Kristine E Ensrud, Allyson M Kats, John T Schousboe, Brent C Taylor, Peggy M Cawthon, Teresa A Hillier, Kristine Yaffe, Steve R Cummings, Jane A Cauley, Lisa Langsetmo and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 3 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 3 syntheses or guidelines pooled it, 135 citations in OpenAlex.

  1. Pooled it
  2. Frailty in COPD: Clinical Impact, Diagnosis, Biomarkers, and Management Strategies.International journal of chronic obstructive pulmonary disease · 2025
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Kristine E EnsrudDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota.ORCID http://orcid.org/0000-0002-9069-3036
Allyson M KatsDivision of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
John T SchousboeHealthPartners Institute, Bloomington, Minnesota.
Brent C TaylorDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota.
Peggy M CawthonCalifornia Pacific Medical Center Research Institute, San Francisco, California.
Teresa A HillierCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
Kristine YaffeDepartment of Psychiatry, University of California, San Francisco, San Francisco, California.
Steve R CummingsCalifornia Pacific Medical Center Research Institute, San Francisco, California.
Jane A CauleyDepartment of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Lisa LangsetmoDivision of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
Study of Osteoporotic Fractures
University of Minnesota · USUniversity of California, San Francisco · USCalifornia Pacific Medical Center · USKaiser Permanente Center for Health Research · USUniversity of Pittsburgh · US

Funding

Study of Osteoporotic FracturesR01AG005407 · NIA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI CUMMINGS, STEVEN RON, YAFFE, KRISTINE · 1986 to 2016
$23.2M
Study of Osteoporotic FracturesR01AG005394 · NIA · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ENSRUD, KRISTINE · 1986 to 2015
$6.1M
STUDY OF OSTEOPOROTIC FRACTURES: VERTEBRAL FRACTURESR01AR035583 · NIAMS · KAISER FOUNDATION RESEARCH INSTITUTE · PI HILLIER, TERESA A · 1986 to 2005
$3.2M
Study of Osteoporotic Fractures (SOF)R01AG027574 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI HILLIER, TERESA A · 2006 to 2015
$2.6M
Study of Osteoporotic Fractures (SOF)-Pittsburgh ClinicR01AG027576 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE ANN · 2006 to 2015
$2.4M
Study of Osteoporotic FracturesR01AR035582 · NIAMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CAULEY, JANE · 1986 to 2005
$2.4M
Study of Osteoporotic FracturesR01AR035584 · NIAMS · UNIVERSITY OF MARYLAND BALTIMORE · PI HOCHBERG, MARC C. · 1986 to 2005
$2.1M
NIAMS NIH HHS R01 AR035582NIAMS NIH HHS R01 AR035583NIAMS NIH HHS R01 AR035584NIA NIH HHS R01 AG005394NIA NIH HHS R01 AG005407NIA NIH HHS R01 AG027574NIA NIH HHS R01 AG027576
6 · The paper itself

Abstract

objectivesTo determine the association of the frailty phenotype with subsequent healthcare costs and utilization.

designProspective cohort study (Study of Osteoporotic Fractures (SOF)).

settingFour U.S. sites.

participantsCommunity-dwelling women (mean age 80.2) participating in SOF Year 10 (Y10) examination linked with their Medicare claims data (N=2,150). MEASUREMENTS: At Y10, frailty phenotype defined using criteria similar to those used in the Cardiovascular Health Study frailty phenotype and categorized as robust, intermediate stage, or frail. Participant multimorbidity burden ascertained using claims data. Functional limitations assessed by asking about difficulty performing instrumental activities of daily living. Total direct healthcare costs and utilization ascertained during 12 months after Y10.

resultsMean total annualized cost±standard deviation (2014 dollars) was $3,781±6,920 for robust women, $6,632±12,452 for intermediate stage women, and $10,755 ± 16,589 for frail women. After adjustment for age, site, multimorbidity burden, and cognition, frail women had greater mean total (cost ratio (CR)=1.91, 95% confidence interval (CI)=1.59-2.31) and outpatient (CR=1.55, 95% CI=1.36-1.78) costs than robust women and greater odds of hospitalization (odds ratio (OR)=2.05, 95% CI=1.47-2.87) and a skilled nursing facility stay (OR=3.85, 95% CI=1.88-7.88). There were smaller but significant effects of the intermediate stage category on these outcomes. Individual frailty components (shrinking, poor energy, slowness, low physical activity) were also each associated with higher total costs. Functional limitations partially mediated the association between the frailty phenotype and total costs (CR further adjusted for self-reported limitations=1.32, 95% CI=1.07-1.63 for frail vs robust; CR=1.35, 95% CI=1.18-1.55 for intermediate stage vs robust women).

conclusionIntermediate stage and frail older community-dwelling women had higher subsequent total healthcare costs and utilization after accounting for multimorbidity and functional limitations. Frailty phenotype assessment may improve identification of older adults likely to require costly, extensive care.

Indexed as

AgedAged, 80 and overFemaleFollow-Up StudiesFrail ElderlyFrailtyGeriatric AssessmentHealth Care CostsHumansOsteoporotic FracturesProspective StudiesRisk Factorsfrailtyhealthcare costshealthcare utilizationmultimoribidity

Identifiers

PMID29684237
PMCPMC6097947
OpenAlexW2801803169

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.