Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies

Natalie D Jenkins; Emiel O Hoogendijk; Joshua J Armstrong; Nathan A Lewis; Janice M Ranson; Judith J M Rijnhart; Tamer Ahmed; Ahmed Ghachem; Donncha S Mullin; Eva Ntanasi; Miles Welstead; Mohammad Auais; David A Bennett; Stefania Bandinelli; Matteo Cesari; Luigi Ferrucci; Simon D French; Martijn Huisman; David J Llewellyn; Nikolaos Scarmeas; Andrea M Piccinin; Scott M Hofer; Graciela Muniz-Terrera

doi:10.1093/geroni/igab059

Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies

Natalie D Jenkins, Emiel O Hoogendijk, Joshua J Armstrong, Nathan A Lewis, Janice M Ranson, Judith J M Rijnhart, Tamer Ahmed, Ahmed Ghachem, Donncha S Mullin, Eva Ntanasi, Miles Welstead, Mohammad Auais, David A Bennett, Stefania Bandinelli, Matteo Cesari, Luigi Ferrucci, Simon D French, Martijn Huisman, David J Llewellyn, Nikolaos ScarmeasAndrea M Piccinin, Scott M Hofer, Graciela Muniz-Terrera

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND AND OBJECTIVES: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education.

RESEARCH DESIGN AND METHODS: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term.

RESULTS: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves.

DISCUSSION AND IMPLICATIONS: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

Original language	English
Article number	igab059
Pages (from-to)	1-11
Number of pages	11
Journal	Innovation in Aging
Volume	6
Issue number	2
Early online date	15 Jan 2022
DOIs	https://doi.org/10.1093/geroni/igab059
Publication status	Published - 2022

Bibliographical note

Funding

This work was supported by the National Institutes of Health (P01AG043362, R01AG067621) awarded to S. M. Hofer; the Netherlands Organisation for Scientific Research ZonMw-Veni fellowship (91618067) awarded to E. O. Hoogendijk; Age UK (MR/M01311/1) awarded to M. Welstead; the Halpin Trust awarded to J. M. Ranson and D. J. Llewellyn; Alzheimer’s Research UK awarded to J. M. Ranson and D. J. Llewellyn; Mary Kinross Charitable Trust awarded to D. J. Llewellyn; the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula awarded to D. J. Llewellyn; the National Institute on Aging/National Institutes of Health (RF1AG055654) awarded to D. J. Llewellyn; and the Alan Turing Institute under the Engineering and Physical Sciences Research Council grant (EP/N510129/1) awarded to D. J. Llewellyn.

Funders	Funder number
Halpin Trust
Mary Kinross Charitable Trust
Netherlands Organisation for Scientific Research ZonMw-Veni	MR/M01311/1, 91618067
National Institutes of Health	R01AG067621, P01AG043362
National Institute on Aging	RF1AG055654
Alan Turing Institute
Engineering and Physical Sciences Research Council	EP/N510129/1
National Institute for Health and Care Research
Alzheimer’s Research UK

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Jenkins, N. D., Hoogendijk, E. O., Armstrong, J. J., Lewis, N. A., Ranson, J. M., Rijnhart, J. J. M., Ahmed, T., Ghachem, A., Mullin, D. S., Ntanasi, E., Welstead, M., Auais, M., Bennett, D. A., Bandinelli, S., Cesari, M., Ferrucci, L., French, S. D., Huisman, M., Llewellyn, D. J., ... Muniz-Terrera, G. (2022). Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies. Innovation in Aging, 6(2), 1-11. Article igab059. https://doi.org/10.1093/geroni/igab059

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title = "Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies",

abstract = "BACKGROUND AND OBJECTIVES: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education.RESEARCH DESIGN AND METHODS: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term.RESULTS: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves.DISCUSSION AND IMPLICATIONS: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.",

author = "Jenkins, {Natalie D} and Hoogendijk, {Emiel O} and Armstrong, {Joshua J} and Lewis, {Nathan A} and Ranson, {Janice M} and Rijnhart, {Judith J M} and Tamer Ahmed and Ahmed Ghachem and Mullin, {Donncha S} and Eva Ntanasi and Miles Welstead and Mohammad Auais and Bennett, {David A} and Stefania Bandinelli and Matteo Cesari and Luigi Ferrucci and French, {Simon D} and Martijn Huisman and Llewellyn, {David J} and Nikolaos Scarmeas and Piccinin, {Andrea M} and Hofer, {Scott M} and Graciela Muniz-Terrera",

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year = "2022",

doi = "10.1093/geroni/igab059",

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volume = "6",

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Jenkins, ND, Hoogendijk, EO, Armstrong, JJ, Lewis, NA, Ranson, JM, Rijnhart, JJM, Ahmed, T, Ghachem, A, Mullin, DS, Ntanasi, E, Welstead, M, Auais, M, Bennett, DA, Bandinelli, S, Cesari, M, Ferrucci, L, French, SD, Huisman, M, Llewellyn, DJ, Scarmeas, N, Piccinin, AM, Hofer, SM & Muniz-Terrera, G 2022, 'Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies', Innovation in Aging, vol. 6, no. 2, igab059, pp. 1-11. https://doi.org/10.1093/geroni/igab059

TY - JOUR

T1 - Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies

AU - Jenkins, Natalie D

AU - Hoogendijk, Emiel O

AU - Armstrong, Joshua J

AU - Lewis, Nathan A

AU - Ranson, Janice M

AU - Rijnhart, Judith J M

AU - Ahmed, Tamer

AU - Ghachem, Ahmed

AU - Mullin, Donncha S

AU - Ntanasi, Eva

AU - Welstead, Miles

AU - Auais, Mohammad

AU - Bennett, David A

AU - Bandinelli, Stefania

AU - Cesari, Matteo

AU - Ferrucci, Luigi

AU - French, Simon D

AU - Huisman, Martijn

AU - Llewellyn, David J

AU - Scarmeas, Nikolaos

AU - Piccinin, Andrea M

AU - Hofer, Scott M

AU - Muniz-Terrera, Graciela

PY - 2022

Y1 - 2022

N2 - BACKGROUND AND OBJECTIVES: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education.RESEARCH DESIGN AND METHODS: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term.RESULTS: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves.DISCUSSION AND IMPLICATIONS: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

AB - BACKGROUND AND OBJECTIVES: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education.RESEARCH DESIGN AND METHODS: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term.RESULTS: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves.DISCUSSION AND IMPLICATIONS: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

U2 - 10.1093/geroni/igab059

DO - 10.1093/geroni/igab059

M3 - Article

C2 - 35233470

SN - 2399-5300

VL - 6

SP - 1

EP - 11

JO - Innovation in Aging

JF - Innovation in Aging

IS - 2

M1 - igab059

ER -

Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies

Abstract

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Funding

UN SDGs

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