ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
The Burden of Frailty Among U.S. Veterans and Its Association With Mortality, 2002-2012.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 135 papers, 2 of them syntheses that pooled it.
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Who cites it
135 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Assessing causality between inflammatory bowel diseases with frailty index and sarcopenia: a bidirectional Mendelian randomization study.European journal of medical research · 2024Pooled it
- Trial
- Statins, Mortality, and Major Adverse Cardiovascular Events Among US Veterans With Chronic Kidney Disease.JAMA network open · 2023Trial
- More intensive therapy as more effective treatment for frail patients with multiple myeloma [corrected].Blood advances · 2023Trial
- Effect of Vitamin D3 and Omega-3 Fatty Acid Supplementation on Risk of Frailty: An Ancillary Study of a Randomized Clinical Trial.JAMA network open · 2022Trial
- Frailty and Fitness in Older Adults With Acute Myeloid Leukemia: From Chronological Age to Multiparametric Assessment.European journal of haematology · 2026Review
- Evaluating a Pragmatic Strength Alternative for Frailty Measurement and Assessing Its Predictive Capacity Against Established Frailty Instruments in Rheumatoid Arthritis.Arthritis care & research · 2026Article
- Article
- Continuous Glucose Monitoring and Mortality Risk Among U.S. Veterans Receiving Dialysis With Diabetes.Diabetes care · 2026Article
- Life-Sustaining Treatment Documentation in VA Home Based Primary Care Improves With Feedback Reports and Facilitation.Journal of the American Geriatrics Society · 2026Article
- Frailty Predicts Incident Osteoporotic Fractures in Veterans with Rheumatoid Arthritis.Arthritis care & research · 2026Article
- Statins and survival free of incident frailty among older US veterans.European heart journal · 2026Article
- Medicare costs and home time loss among fee-for-service beneficiaries by frailty and dementia status.The Journal of frailty & aging · 2026Article
- Initiation of Medications for Alcohol Use Disorder Among Hospitalized Veterans : A Retrospective Cohort Study.Annals of internal medicine · 2026Article
- Predicting Protracted Recovery and Long-Term Loss of Independence after Major Surgery in Veterans.Annals of surgery · 2026Article
- Article
- The impact of frailty on postoperative outcomes of veterans with stage I non-small cell lung cancer.Surgery · 2026Article
- How does Frailty Impact Peri-Operative and Speech Recognition Outcomes for Cochlear Implants in Veterans?Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Evaluating Frailty Index Integrity: Insights from an International Network Study.medRxiv : the preprint server for health sciences · 2026Article
75 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors.
Funding
Abstract
backgroundFrailty is a key determinant of clinical outcomes. We sought to describe frailty among U.S. Veterans and its association with mortality.
methodsNationwide retrospective cohort study of regular Veterans Affairs (VA) users, aged at least 65 years in 2002-2012, followed through 2014, using national VA administrative and Medicare and Medicaid data. A frailty index (FI) for VA (VA-FI) was calculated using the cumulative deficit method. Thirty-one age-related deficits in health from diagnostic and procedure codes were included and were updated biennially. Survival analysis assessed associations between VA-FI and mortality.
resultsA VA-FI was calculated for 2,837,152 Veterans over 10 years. In 2002, 35.5% were non-frail (FI = 0-0.10), 32.6% were pre-frail (FI = 0.11-0.20), 18.9% were mildly frail (FI = 0.21-0.30), 8.7% were moderately frail (FI = 0.31-0.40), and 4.3% were severely frail (FI > 0.40). From 2002 to 2012, the prevalence of moderate frailty increased to 12.7%and severe frailty to 14.1%. Frailty was strongly associated with survival and was independent of age, sex, race, and smoking; the VA-FI better predicted mortality than age alone. Although prevalence of frailty rose over time, compared to non-frail Veterans, 2 years' hazard ratios (95% confidence intervals) for mortality declined from a peak in 2004 of 2.01 (1.97-2.04), 3.49 (3.44-3.55), 5.88 (5.79-5.97), and 10.39 (10.23-10.56) for pre-frail, mildly, moderately, and severely frail, respectively, to 1.51 (1.49-1.53), 2.36 (2.33-2.39), 3.68 (3.63-3.73), 6.62 (6.53-6.71) in 2012. At every frailty level, risk of mortality was lower for women versus men and higher for blacks versus whites.
conclusionsFrailty affects at least 3 of every 10 U.S. Veterans aged 65 years and older, and is strongly associated with mortality. The VA-FI could be used to more accurately estimate life expectancy and individualize care for Veterans.
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