ArticleJournal of the American Geriatrics Society2021
Changes in a Frailty Index and Association with Mortality.
Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Global Prevalence of Cognitive Frailty in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.Asia-Pacific psychiatry : official journal of the Pacific Rim College of Psychiatrists · 2026Pooled it
- The prevalence of frailty among older adults with maintenance hemodialysis: a systematic.BMC nephrology · 2025Pooled it
- Frailty and the efficacy and safety of surgical versus endovascular revascularization: post-hoc analysis of the BEST-CLI trial.The British journal of surgery · 2026Trial
- A hybrid type 1 trial of a digital behaviour change intervention for frailty prevention in community-dwelling older adults aged 60 years and older.Age and ageing · 2026Trial
- Tai Chi versus health education as a frailty intervention for community-dwelling older adults with hypertension.Aging clinical and experimental research · 2023Trial
- Longitudinal dynamics in frailty and incident all-cause dementia: a multicohort study.Journal of advanced research · 2026Article
- Randomized Controlled Trial of Individualized Intervention for Frailty Reversal in Older Patients With Nondialysis CKD.Kidney international reports · 2026Article
- Frailty and prefrailty are associated with increased risk of aortic aneurysm but not aortic dissection: a prospective cohort study of UK biobank participants.BMC cardiovascular disorders · 2026Article
- CRT upgrade improves frailty status in patients with HFrEF and RV pacing-a post hoc analysis of the BUDAPEST-CRT trial.GeroScience · 2026Article
- Long-Term Functional Outcomes After Prehabilitation in Frail Older Adults Undergoing Colorectal Cancer Surgery: A One-Year Prospective Cohort Study.Journal of clinical medicine · 2026Article
- Association of Frailty and Frailty Trajectory with Risk for Respiratory Infectious Diseases.Emerging infectious diseases · 2026Article
- Estimated Cardiorespiratory Fitness and Risk of Incident Frailty in Middle-Aged and Older Adults: A Cross-National Longitudinal Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Utility of biological aging markers for mortality risk stratification in community-dwelling older adults: insights from the Mr. OS and Ms. OS (Hong Kong) cohort.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Associations of summary measures of longitudinal frailty assessments with health outcomes.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Association of frailty with fragility fractures and all‑cause mortality in adults: evidence from the National Health and Nutrition Examination Survey.BMC musculoskeletal disorders · 2026Article
- Inflammation meets insulin resistance: the role of the CRP-triglyceride-glucose index in association with frailty among middle-aged and older adults in China.European journal of medical research · 2026Article
- Changes in frailty and incident risk of degenerative bone and joint diseases and their multimorbidity: a prospective cohort study.Frontiers in public health · 2026Article
- Prediction model for postoperative delirium risk in elderly hypertensive patients: machine learning-based development and validation.Frontiers in psychiatry · 2026Article
- Longitudinal changes in frailty, insulin resistance and incident cardiovascular-kidney- metabolic syndrome progression in middle-aged and older adults: evidence from CHARLS.Diabetology & metabolic syndrome · 2025Article
- Antiretroviral Therapy Changes for Medicare Beneficiaries With HIV Transitioning to Long-Term Care.JAMA network open · 2025Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundAlthough frailty status is dynamic, whether improvements in frailty predict mortality is unknown.
objectiveDescribe 1-year changes in a frailty index (FI) and association with 48-month mortality.
designSecondary analysis of the National Health in Aging Trends Study.
settingCommunity.
participantsFive thousand six hundred and seventy two Medicare beneficiaries 65 and older (3,267 (55.8%) females). MEASUREMENTS: A 40-item deficit accumulation FI was measured in 2011 and 2012, based on multidomain assessment including comorbidities, activities of daily living, physical tasks, cognition, and performance testing. We categorized 2011 FI into robust (FI < 0.15), pre-frail (FI = 0.15-0.24), mild frailty (FI = 0.25-0.34), and moderate to severe frailty (FI ≥ 0.35). Change in frailty was calculated as the FI change from 2011 to 2012, categorized as either absolute (>0.045 decrease, 0.015-0.045 decrease, ±0.015 change, 0.015-0.045 increase, >0.045 increase) or proportional change (>20% decrease, 5-20% decrease, ±5% change, 5-20% increase, 20% increase). We measured the association of FI change with 4-year mortality using Cox regression.
resultsFrom 2011 to 2012, mean FI increased by 0.02 (standard deviation 0.07), with 58.6% having an increase. Over 4 years, 1,039 participants (13.6%) died. After adjusting for age and sex, compared to stable frailty (±0.015), both absolute (>0.045) and proportional (>20%) increases in frailty were associated with higher mortality among pre-frail participants (hazard ratio (HR) = 2.35, 95% confidence interval (CI) = (1.45-3.79) and HR (95% CI) = 3.32 (1.76-6.26), respectively), participants with mild frailty (HR (95% CI) = 1.96 (1.35-2.85) and 2.03 (1.37-3.02)) and moderate or severe frailty (HR (95% CI) = 1.99 (1.48-2.67) and 1.94 (1.43-2.63)) but not robust participants (HR (95% CI)= 1.48 (0.86-2.54), HR (95% CI) = 1.62 (0.80-3.28)). However, decreases in FI were not significantly associated with decreased risk of mortality.
conclusionsIncreasing deficit accumulation FI over 1 year is associated with increased mortality risk. While decreasing FI occurs, we did not find evidence to support reduced mortality risk.
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