ArticleBMC public health2023
Frailty as a predictor of mortality: a comparative cohort study of older adults in Costa Rica and the United States.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Association of frailty and mortality risk in community-dwelling older adults: a systematic review and meta-analysis of 59 international prospective cohort studies.BMC public health · 2026Pooled it
- How do glucagon-like Peptide-1 receptor agonists affect measures of muscle mass in individuals with, and without, type 2 diabetes: A systematic review and meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Pooled it
- Suprapubic catheter insertion: a multicentre review on mortality during short-, medium- and long-term follow-up.Annals of the Royal College of Surgeons of England · 2026Article
- Losses to Follow-Up in a Nationally Representative Study of Community-Living Older Americans: Two Approaches to Censoring and Implications for Mortality Outcomes.Journal of the American Geriatrics Society · 2026Article
- Prevalence of Frailty and Associated Sociodemographic, Biomedical, and Biochemical Factors Amongst Participants Residing in Limpopo Province, South Africa.Geriatrics (Basel, Switzerland) · 2025Article
- Incomplete Ascertainment of Mortality in a Nationally Representative Longitudinal Study of Community-Living Older Americans.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Article
- Dynapenia-abdominal obesity and mortality risk, is independent effect obscured by age and frailty?:Birjand Longitudinal Aging Study (BLAS).Journal of diabetes and metabolic disorders · 2024Article
- Development and Validation of a Game for Older Adults on Lifestyles and Frailty.Nursing reports (Pavia, Italy) · 2024Article
- Adherence to the Mediterranean Diet Mitigates Inflammation and Hospital Stay in Frail Elderly Patients: A Moderation Analysis.Nutrients · 2024Article
- Associations of Frailty, Defined Using Three Different Instruments, with All-Cause Mortality in a Tertiary Outpatient Clinic in Turkiye.International journal of general medicine · 2024Article
- Depression and Plasma pTauGerontology & geriatric medicineArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFrailty is a common condition among older adults that results from aging-related declines in multiple systems. Frailty increases older adults' vulnerability to negative health outcomes, including loss of mobility, falls, hospitalizations, and mortality. The aim of this study is to examine the association between frailty and mortality in older adults from Costa Rica and the United States.
methodsThis prospective cohort study uses secondary nationally-representative data of community-dwelling older adults from the Costa Rican Longevity and Healthy Aging Study (CRELES, n = 1,790) and the National Health & Aging Trends Study (NHATS, n = 6,680). Frailty status was assessed using Physical Frailty Phenotype, which includes the following five criteria: shrinking, exhaustion, low physical activity, muscle weakness, and slow gait. We used Cox proportional hazard models to examine the association between frailty and all-cause mortality, including sociodemographic characteristics and health behaviors as covariates in the models. Mortality follow-up time was right censored at 8 years from the date at baseline interview.
resultsThe death hazard for frail compared to non-frail older adults was three-fold in Costa Rica (HR = 3.14, 95% CI: 2.13-4.62) and four-fold in the White US (HR = 4.02, 95% CI: 3.04-5.32). Older age, being male, and smoking increased mortality risk in both countries. High education was a protective factor in the US, whereas being married/in union was a protective factor in Costa Rica. In the US, White older adults had a lower risk of death compared to all other races and ethnicities.
conclusionsResults indicate that frailty can have a differential impact on mortality depending on the country. Access to universal health care across the life course in Costa Rica and higher levels of stress and social isolation in the US may explain differences observed in end-of-life trajectories among frail older adults.
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