ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2026
Physical frailty, self-rated health, and all-cause mortality: implications for understanding resilience in aging.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Past-Month Tobacco and Cannabis Co-Use by Chronic Disease and Sociodemographic Factors Among U.S. Adults 65+ Years (2021-2023).Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
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5 authors.
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Abstract
backgroundFrailty and poor self-rated health (SRH) as potential indicators of reduced resilience are associated with all-cause mortality. However, it is lesser known whether these associations are independent of each other, physical disability or disease burden, and whether SRH remains predictive of mortality among frail older adults.
methodsWe leveraged the National Health and Aging Trends Study of US Medicare beneficiaries, followed annually from 2011 to 2019. Baseline assessments included physical frailty and SRH (excellent/very good, good, or fair/poor). Cox models examined associations with all-cause mortality, adjusting for demographic characteristics and comorbidities. Sensitivity analyses excluded participants with probable or possible dementia at baseline.
resultsOf the 7425 participants at baseline, 14% were physically frail, and 25% reported fair/poor SRH. Although frailty was positively correlated with fair/poor SRH, 12% of frail participants reported excellent/very good health, and 6.6% of those with fair/poor SRH were non-frail. Over a median follow-up of 4.3 years, 29% died. Compared to non-frail participants, pre-frailty and frailty were associated with 1.4- and 2.0-fold increased hazard of mortality, respectively, after adjusting for SRH (p < .001); reporting good and fair/poor SRH was associated with 29% and 59% higher hazard of mortality compared to excellent/very good SRH, respectively, after adjusting for frailty (p < .001). Fair/poor SRH was associated with higher mortality among the frail. Sensitivity analyses yielded similar results.
conclusionPhysical frailty and SRH, while related, capture distinct aspects of health. Each independently and jointly predicts mortality, with SRH retaining prognostic value in frail individuals. Incorporating both measures may improve risk stratification and guide tailored interventions.
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