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. 2022 Jan 15;6(2):igab059.
doi: 10.1093/geroni/igab059. eCollection 2022.

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

Natalie D Jenkins  1 , Emiel O Hoogendijk  2 , Joshua J Armstrong  3 , Nathan A Lewis  4 , Janice M Ranson  5 , Judith J M Rijnhart  2 , Tamer Ahmed  6 , Ahmed Ghachem  7 , Donncha S Mullin  8   9 , Eva Ntanasi  10 , Miles Welstead  1   8 , Mohammad Auais  6 , David A Bennett  11 , Stefania Bandinelli  12 , Matteo Cesari  13 , Luigi Ferrucci  14 , Simon D French  15 , Martijn Huisman  2 , David J Llewellyn  5   16 , Nikolaos Scarmeas  10   17 , Andrea M Piccinin  4 , Scott M Hofer  4 , Graciela Muniz-Terrera  1
Affiliations

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

Natalie D Jenkins et al. Innov Aging. .

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.

Keywords: Age-related changes; Latent growth curve; Longitudinal.

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Figures

Figure 1.
Figure 1.
A path diagram representing the final models for each cohort. The dotted lines represent the additional adjustment for an age–sex/gender interaction in the final model for the Rush Memory and Aging Project (MAP) cohort only.
Figure 2.
Figure 2.
Graphical representation of the estimated model trajectory of the frailty index across cohorts for: (A) female and male; (B) individuals aged 65 or 67 at baseline.
See this image and copyright information in PMC

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