Evidence map›Paper›PMID 39588718›Full record

ArticleJournal of the American Geriatrics Society2025

Incremental healthcare costs of the simple SOF measure of phenotypic frailty in community-dwelling older adults.

Kristine E Ensrud, John T Schousboe, Allyson M Kats, Howard A Fink, Brent C Taylor, Kerry M Sheets, Cynthia M Boyd, Lisa Langsetmo

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
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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

8 authors.

Kristine E EnsrudDivision of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota, USA.ORCID 0000-0002-9069-3036
John T SchousboeHealthPartners Institute, Bloomington, Minnesota, USA.
Allyson M KatsDivision of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota, USA.
Howard A FinkDivision of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota, USA.
Brent C TaylorDivision of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota, USA.
Kerry M SheetsDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Cynthia M BoydSchool of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Lisa LangsetmoDivision of Epidemiology & Community Health, School of Public Health, Minneapolis, Minnesota, USA.

Funding

The National Health and Trends StudyU01AG032947 · NIA · JOHNS HOPKINS UNIVERSITY · PI VICKI A. FREEDMAN, JENNIFER ANN SCHRACK · 2008 to 2026
$169.4M
Oregon Clinical and Translational Research InstituteUL1TR000128 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI ELLISON, DAVID H · 2012 to 2015
$28.7M
Study of Osteoporotic FracturesR01AG005407 · NIA · UNIVERSITY OF CALIFORNIA SAN FRANCISCO · PI CUMMINGS, STEVEN RON, YAFFE, KRISTINE · 1986 to 2016
$23.2M
Long term fracture risk and change in peripheral bone in the oldest old men: The MrOS studyR01AG066671 · NIA · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI BOUXSEIN, MARY L, CAWTHON, PEGGY MANNEN · 2020 to 2024
$13.3M
Osteoporotic Fractures in Men (MrOS) - San Francisco Coordinating CenterU01AR066160 · NIAMS · CALIFORNIA PACIFIC MED CTR RES INSTITUTE · PI CUMMINGS, STEVEN RON · 2013 to 2017
$9.3M
Study of Osteoporotic FracturesR01AG005394 · NIA · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ENSRUD, KRISTINE · 1986 to 2015
$6.1M
Osteoporotic Fractures in Men (MrOS) - MinneapolisU01AG042145 · NIA · UNIVERSITY OF MINNESOTA · PI ENSRUD, KRISTINE · 2013 to 2019
$5.3M
Osteporotic Fractures in Men (MrOS)- Admin CenterU01AG027810 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2006 to 2017
$5.1M
Peripheral Nerve Function Decline in an Aged CohortR01AG028050 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STROTMEYER, ELSA S. · 2007 to 2015
$3.5M
STUDY OF OSTEOPOROTIC FRACTURES: VERTEBRAL FRACTURESR01AR035583 · NIAMS · KAISER FOUNDATION RESEARCH INSTITUTE · PI HILLIER, TERESA A · 1986 to 2005
$3.2M
Osteoporotic Fractures in Men (MrOS) - PortlandU01AG042124 · NIA · OREGON HEALTH & SCIENCE UNIVERSITY · PI ORWOLL, ERIC S. · 2013 to 2019
$3.0M
Osteoporatic Fractures in Men (MrOS)U01AG042168 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KADO, DEBORAH · 2013 to 2017
$3.0M
AHRQ HHS P30 HS029744NCATS NIH HHS UL1 TR000128NCATS NIH HHS UL1TR000128NIAMS NIH HHS R01 AR035582NIAMS NIH HHS R01 AR035583NIAMS NIH HHS R01 AR035584NIAMS NIH HHS R01AR35582NIAMS NIH HHS R01AR35583NIAMS NIH HHS R01AR35584NIAMS NIH HHS U01 AR066160NIAMS NIH HHS U01AR066160NIA NIH HHS N01-AG-6-2101NIA NIH HHS N01-AG-6-2103NIA NIH HHS N01-AG-6-2106NIA NIH HHS R01 AG005394NIA NIH HHS R01 AG005407NIA NIH HHS R01 AG027574NIA NIH HHS R01 AG027576NIA NIH HHS R01 AG028050NIA NIH HHS R01-AG028050NIA NIH HHS R01 AG066671NIA NIH HHS R01AG066671NIA NIH HHS R01 AG067973NIA NIH HHS R01AG067973NIA NIH HHS U01 AG027810NIA NIH HHS U01AG027810NIA NIH HHS U01 AG032947NIA NIH HHS U01 AG042124NIA NIH HHS U01AG042124NIA NIH HHS U01 AG042139NIA NIH HHS U01AG042139NIA NIH HHS U01 AG042140NIA NIH HHS U01AG042140NIA NIH HHS U01 AG042143NIA NIH HHS U01AG042143NIA NIH HHS U01 AG042145NIA NIH HHS U01AG042145NIA NIH HHS U01 AG042168NIA NIH HHS U01AG042168NIA NIH HHS U01AG32947NINR NIH HHS R01 AG066671NINR NIH HHS R01 NR012459NINR NIH HHS R01-NR012459NINR NIH HHS U01 AG027810NINR NIH HHS U01 AG042124NINR NIH HHS U01 AG042139NINR NIH HHS U01 AG042140NINR NIH HHS U01 AG042143NINR NIH HHS U01 AG042145NINR NIH HHS U01 AG042168NINR NIH HHS U01 AR066160NINR NIH HHS UL1 TR000128
6 · The paper itself

Abstract

backgroundFrailty defined by the Cardiovascular Health Study (CHS) phenotype is associated with higher healthcare expenditures in community-dwelling Medicare beneficiaries after accounting for claims-based cost indicators. However, frailty assessment using the CHS phenotype is often not feasible in routine clinical practice. We evaluated whether frailty identified by the simple Study of Osteoporotic Fractures (SOF) phenotype is associated with subsequent incremental costs after accounting for claims-derived cost indicators.

methodsProspective study utilizing data from four cohort studies of older adults linked with Medicare claims composed of 8264 community-dwelling fee-for-service beneficiaries (4389 women, 3875 men). SOF Frailty Phenotype (three components: weight loss, poor energy, and inability to rise from chair five times without using arms) and CHS Frailty Phenotype (operationalized using five components) derived from cohort data. Participants were classified as robust, prefrail, or frail using each phenotype. Multimorbidity index (CMS Hierarchical Conditions Categories score) and Kim frailty indicator (approximating the deficit accumulation index) derived from claims. Annualized total and sector-specific healthcare costs ascertained for 36 months after frailty assessment.

resultsAverage annualized total healthcare costs (2023 US dollars) were $15,021 in women and $15,711 in men. After accounting for claims-based multimorbidity and frailty indicators, average incremental costs of SOF phenotypic frailty (two or three components) versus robust (none) were $7142 in women and $5961 in men, only modestly lower than incremental costs of CHS phenotypic frailty ($9422 in women, $6479 in men). SOF phenotypic frailty in both sexes was associated with higher subsequent expenditures in the inpatient, skilled nursing facility, and home healthcare sectors.

conclusionsAs observed with CHS phenotypic frailty, SOF phenotypic frailty is associated with higher subsequent total and sector-specific expenditures after accounting for claims-derived indicators. The parsimonious SOF phenotype can be readily assessed in space-constrained and time-limited practice settings to improve identification of older adults at high risk of costly care.

Indexed as

Frail ElderlyFrailtyGeriatric AssessmentHealth Care CostsIndependent LivingOsteoporotic FracturesAgedAged, 80 and overFemaleHumansMaleMedicarePhenotypeProspective StudiesUnited Statesfrailty phenotypehealthcare expendituresMedicare claims datamultimorbidity

Identifiers

PMID39588718
PMCPMC11907753

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