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12.06.2018 | Original Article | Ausgabe 10/2018 Open Access

Osteoporosis International 10/2018

Progression of frailty and prevalence of osteoporosis in a community cohort of older women—a 10-year longitudinal study

Zeitschrift:
Osteoporosis International > Ausgabe 10/2018
Autoren:
P. Bartosch, F. E. McGuigan, K. E. Akesson
Wichtige Hinweise
The original version of this article was revised due to an updated licence text.
A correction to this article is available online at https://​doi.​org/​10.​1007/​s00198-019-04876-0.
A correction to this article is available online at https://​doi.​org/​10.​1007/​s00198-019-04877-z.

Abstract

Summary

In community dwelling, 75-year-old women followed 10 years, a frailty index was created at each of three visits. Frailty score increased by ~ 6–7% annually. A higher frailty score was equivalent to being 5–10 years chronologically older. Frailty was associated with low bone density and higher risk of dying.

Introduction

To understand the distribution of frailty among a population-based sample of older community-dwelling women, progression over 10 years, and association with mortality and osteoporosis.

Methods

The study is performed in a cohort designed to investigate osteoporosis. The OPRA cohort consists of 75-year-old women, n = 1044 at baseline, and follow-up at age 80 and 85. A frailty index (scored from 0.0–1.0) based on deficits in health across multiple domains was created at all time-points; outcomes were mortality up to 15 years and femoral neck bone density.

Results

At baseline, the proportion least frail, i.e., most robust (FI 0.0–0.1) constituted 48%, dropping to 25 and 14% at age 80 and 85. On average, over 10 years, the annual linear frailty score progression was approximately 6–7%. Among the least frail, 11% remained robust over 10 years. A higher frailty score was equivalent to being 5 to 10 years older. Mortality was substantially higher in the highest quartile compared to the lowest based on baseline frailty score; after 10 years, 48.7% had died vs 17.2% (p = 1.7 × 10−14). Mortality risk over the first 5 years was highest in the frailest (Q4 vs Q1; HRunadj 3.26 [1.86–5.73]; p < 0.001) and continued to be elevated at 10 years (HRunadj 3.58 [2.55–5.03]; p < 0.001). Frailty was associated with BMD after adjusting for BMI (overall p = 0.006; Q1 vs Q4 p = 0.003).

Conclusions

The frailty index was highly predictive of mortality showing a threefold increased risk of death in the frailest both in a shorter and longer perspective. Only one in ten older women escaped progression after 10 years. Frailty and osteoporosis were associated.

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