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European Journal of Epidemiology

, Volume 29, Issue 6, pp 419–427 | Cite as

Adverse outcomes of frailty in the elderly: the Rotterdam Study

  • Lies Lahousse
  • Bastiaan Maes
  • Gijsbertus Ziere
  • Daan W. Loth
  • Vincentius J. A. Verlinden
  • M. Carola Zillikens
  • André G. Uitterlinden
  • Fernando Rivadeneira
  • Henning Tiemeier
  • Oscar H. Franco
  • M. Arfan Ikram
  • Albert Hofman
  • Guy G. Brusselle
  • Bruno H. StrickerEmail author
GERIATRIC EPIDEMIOLOGY

Abstract

To investigate the prevalence of frailty in a Dutch elderly population and to identify adverse health outcomes associated with the frailty phenotype independent of the comorbidities. Cross-sectional and longitudinal analyses within the Rotterdam Study (the Netherlands), a prospective population-based cohort study in persons aged ≥55 years. Frailty was defined as meeting three or more of five established criteria for frailty, evaluating nutritional status, physical activity, mobility, grip strength and exhaustion. Intermediate frailty was defined as meeting one or two frailty criteria. Comorbidities were objectively measured. Health outcomes were assessed by means of questionnaires, physical examinations and continuous follow-up through general practitioners and municipal health authorities for mortality. Of 2,833 participants (median age 74.0 years, inter quartile range 9) with sufficiently evaluated frailty criteria, 163 (5.8 %) participants were frail and 1,454 (51.3 %) intermediate frail. Frail elderly were more likely to be older and female, to have an impaired quality of life and to have fallen or to have been hospitalized. 108 (72.0 %) frail participants had ≥2 comorbidities, compared to 777 (54.4 %) intermediate frail and 522 (44.8 %) non-frail participants. Adjusted for age, sex and comorbidities, frail elderly had a significantly increased risk of dying within 3 years (HR 3.4; 95 % CI 1.9–6.4), compared to the non-frail elderly. This study in a general Dutch population of community-dwelling elderly able to perform the frailty tests, demonstrates that frailty is common and that frail elderly are at increased risk of death independent of comorbidities.

Keywords

Frail elderly Weight loss Grip strength Physical activity Mortality 

Abbreviations

BMI

Body mass index

CES-D

Center for epidemiological studies depression

CI

Confidence interval

COPD

Chronic obstructive pulmonary disease

FEV1

Forced expiratory volume in 1 s

FVC

Forced vital capacity

Hb

Hemoglobin

HR

Hazard ratio

IQR

Inter quartile range

OR

Odds ratio

QoL

Quality of life

RS

Rotterdam Study

WBC

White blood cells

Notes

Acknowledgments

The authors thank the study participants, the staff from the Rotterdam Study, J. Verkroost, F. van Rooij, M. Leening, R. Ruiter and the participating general practitioners. This study was supported by the Fund for Scientific Research Flanders (FWO) project G035014 N. The funding source had no involvement in the collection, analysis, writing, interpretation, nor in the decision to submit the paper for publication. Researchers were independent from funders for this work.

Conflict of interest

None of the authors has important conflicts of interest with relevance to the submitted work.

Supplementary material

10654_2014_9924_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 15 kb)

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Lies Lahousse
    • 1
    • 2
  • Bastiaan Maes
    • 1
    • 2
  • Gijsbertus Ziere
    • 2
  • Daan W. Loth
    • 2
  • Vincentius J. A. Verlinden
    • 2
    • 3
  • M. Carola Zillikens
    • 4
    • 7
  • André G. Uitterlinden
    • 2
    • 4
    • 7
  • Fernando Rivadeneira
    • 2
    • 4
    • 7
  • Henning Tiemeier
    • 2
    • 7
  • Oscar H. Franco
    • 2
    • 7
  • M. Arfan Ikram
    • 2
    • 3
    • 5
    • 7
  • Albert Hofman
    • 2
    • 7
  • Guy G. Brusselle
    • 1
    • 2
    • 6
  • Bruno H. Stricker
    • 2
    • 7
    • 8
    Email author
  1. 1.Department of Respiratory Medicine, Ghent University HospitalGhent UniversityGhentBelgium
  2. 2.Departments of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Departments of RadiologyErasmus Medical CenterRotterdamThe Netherlands
  4. 4.Departments of Internal MedicineErasmus Medical CenterRotterdamThe Netherlands
  5. 5.Departments of NeurologyErasmus Medical CenterRotterdamThe Netherlands
  6. 6.Departments of Respiratory MedicineErasmus Medical CenterRotterdamThe Netherlands
  7. 7.Netherlands Consortium on Healthy Aging (NCHA)LeidenThe Netherlands
  8. 8.Inspectorate of HealthcareThe HagueThe Netherlands

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