Affiliation:
1. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Solna , Sweden
2. Stockholm Gerontology Research Center , Stockholm , Sweden
3. Department of Clinical and Experimental Sciences, University of Brescia , Brescia , Italy
Abstract
Abstract
Background
This study aims to examine temporal trends in frailty state transitions, and years spent frail, in older Swedish adults.
Methods
We followed the Swedish National Study on Aging and Care in Kungsholmen participants from baseline (2001–2004) for 15 (median: 9.6) years. A 40-deficit frailty index (FI) was constructed to identify 3 frailty states: robust (FI ≤ 0.125), mild frailty (0.125 < FI ≤ 0.25), and moderate and severe frailty (FI > 0.25). Multistate survival analyses were implemented to obtain hazard ratios (HRs) for frailty state transitions, with birth year and sex as predictors. To examine temporal trends, frailty state-specific life expectancies at age 60 were forecasted for robust persons born in different years (1900, 1910, 1920, 1930, and 1940), also by sex.
Results
At baseline, the 2 941 participants’ mean age was 75 years and 65% were women. Predicted life expectancy and time spent frail from age 60 followed an increasing trend by birth year. Hazards of transitioning from mild frailty to death (HR: 0.89; 95% confidence interval [CI]: 0.83–0.97) and moderate and severe frailty to death (HR: 0.98; 95% CI: 0.97–1.00) were lower for those born later. Women were less likely to transition from robust to mild frailty (HR: 0.81; 95% CI: 0.70–0.93), mild frailty to moderate and severe frailty (HR: 0.80; 95% CI: 0.68–0.93), and moderate and severe frailty to death (HR: 0.68; 95% CI: 0.59–0.78), but spent more time frail.
Conclusions
Our results point to an expansion of time spent frail among older Swedish adults over time.
Funder
Swedish Ministry of Health and Social Affairs
Swedish Research Council
Swedish Research Council for Health, Working Life and Welfare
Publisher
Oxford University Press (OUP)
Subject
Geriatrics and Gerontology,Aging
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