ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2021
Trajectories of Frailty in the 5 Years Prior to Death Among U.S. Veterans Born 1927-1934.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Trajectory of frailty among the older people in a community setting: A cohort study from the Shizuoka Kokuho Database.Aging clinical and experimental research · 2026Article
- Associations of summary measures of longitudinal frailty assessments with health outcomes.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- A survey on the trajectory of frailty in the middle-aged and elderly population in the Chengdu community: a retrospective observational study.BMC public health · 2025Observational
- Mapping the Final Journey: End-Of-Life Frailty Trajectories and Cause of Death.Journal of the American Geriatrics Society · 2025Article
- Progression of frailty and cardiovascular outcomes among Medicare beneficiaries.Journal of the American Geriatrics Society · 2024Article
- Progression of Frailty and Cardiovascular Outcomes Among Medicare Beneficiaries.medRxiv : the preprint server for health sciences · 2024Article
- Identifying Frailty in Administrative Databases: A Narrative Review.The Journal of frailty & aging · 2024Review
- Contribution of Frailty to Multimorbidity Patterns and Trajectories: Longitudinal Dynamic Cohort Study of Aging People.JMIR public health and surveillance · 2023Article
- Frailty Trends in an Older Veteran Subpopulation 1 Year Prior and Into the COVID-19 Pandemic Using CAN Scores.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Dynamic frailty risk assessment among older adults with multiple myeloma: A population-based cohort study.Blood cancer journal · 2023Article
- Frailty trajectories and associated factors in the years prior to death: evidence from 14 countries in the Survey of Health, Aging and Retirement in Europe.BMC geriatrics · 2023Article
- How Neighborhood Structural and Individual Characteristics Affect Frailty Progression: Evidence from the China Health and Retirement Longitudinal Study.The journal of nutrition, health & aging · 2023Article
- Natural History Trajectories of Frailty in Community-Dwelling Older Japanese Adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Article
- Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions.Frontiers in public health · 2022Review
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundElectronic frailty indices (eFIs) are increasingly used to identify patients at risk for morbidity and mortality. Whether eFIs capture the spectrum of frailty change, including decline, stability, and improvement, is unknown.
methodsIn a nationwide retrospective birth cohort of U.S. Veterans, a validated eFI, including 31 health deficits, was calculated annually using medical record and insurance claims data (2002-2012). K-means clustering was used to assign patients into frailty trajectories measured 5 years prior to death.
resultsThere were 214 250 veterans born between 1927 and 1934 (mean [SD] age at death = 79.4 [2.8] years, 99.2% male, 90.3% White) with an annual eFI in the 5 years before death. Nine frailty trajectories were identified. Those starting at nonfrail or prefrail had 2 stable trajectories (nonfrail to prefrail, n = 29 786 and stable prefrail, n = 28 499) and 2 rapidly increasing trajectories (prefrail to moderately frail, n = 28 244 and prefrail to severely frail, n = 22 596). Those who were mildly frail at baseline included 1 gradually increasing trajectory (mildly to moderately frail, n = 33 806) and 1 rapidly increasing trajectory (mildly to severely frail, n = 15 253). Trajectories that started at moderately or severely frail included 2 gradually increasing trajectories (moderately to severely frail, n = 27 662 and progressing severely frail, n = 14 478) and 1 recovering trajectory (moderately frail to mildly frail, n = 13 926).
conclusionsNine frailty trajectories, including 1 recovering trajectory, were identified in this cohort of older U.S. Veterans. Future work is needed to understand whether prevention and treatment strategies can improve frailty trajectories and contribute to compression of morbidity toward the end of life.
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