Skip to main content
Log in

Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen study

  • JNHA: Geriatric Science
  • Published:
The journal of nutrition, health & aging

Abstract

Objective

To explore the association of frailty according to questionnaire data (modified Fried criteria) with important endpoints in older men.

Design and setting

Prospective cohort study (the Helsinki Businessmen Study) in Finland.

Participants and measurements

In 1974, clinically healthy men (born 1919–1934, n=1815) of similar socioeconomic status were identified. After a 26-year follow-up in 2000 (mean age 73 years), disease prevalence, mobility-disability, and frailty status (80.9% of survivors, n=1125) were appraised using a postal questionnaire including RAND-36. Four criteria were used for definition: 1) >5% weight loss from midlife, or body mass index (BMI) <21 kg/m2; 2) reported physical inactivity; 3) low vitality (RAND-36); 4) physical weakness (RAND-36). Responders with 3–4, 1–2, and zero criteria were classified as frail (n=108), prefrail (n=567), and nonfrail (n=450), respectively. Eight-year mortality was assessed from registers, and in 2007, survivors were re-assessed with questionnaires.

Results

Nonfrail as referent and adjusted for age, BMI and smoking, both prefrail (HR 2.26; 95% CI, 1.57–3.26), and frail status (4.09; 95% CI, 2.60–6.44) were significant predictors of mortality. Nonfrailty predicted better survival independently of the frailty components, diseases, and disability, and also predicted faster walking speed and less disability 7 years later.

Conclusions

Frailty, and also prefrailty, as defined using questionnaire data (RAND-36) independently predicted important endpoints in older men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Fried LP, Tangen CM, Walston J, et al (2001) Frailty in older adults.: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56A:M146–M156

    Article  Google Scholar 

  2. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G (2004) Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. J Gerontol A Biol Sci Med Sci 59:M255–263.

    Article  Google Scholar 

  3. Bergman H, Ferrucci L, Guralnik J, et al (2007) Frailty: An Emerging Research and Clinical Paradigm-Issues and Controversies. J Gerontol A Biol Sci Med Sci 62: 731–737

    Article  PubMed  Google Scholar 

  4. Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci 62:722–7.

    Article  PubMed  Google Scholar 

  5. Abellan van Kan G, Rolland Y, Bergman H, Morley JE, Kritchevsky SB, Vellas B (2008) The I.A.N.A Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging 12:29–37

    Article  PubMed  CAS  Google Scholar 

  6. Santos-Eggimann B, Cuenoud P, Spagnoli J, et al (2009) Survey of Health, Aging and Retirement in Europe (SHARE) Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Geront A Biol Sci Med Sci 64:675–81

    Article  Google Scholar 

  7. Karunananthan S Wolfson C, Bergman H, Béland F, Hogan DB (2009) A multidisciplinary systematic literature review on frailty: Overview of the methodology used by the Canadian Initiative on Frailty and Aging. BMC Med Res Method 9:68 doi:10.1186/1471-2288-9-68

    Article  Google Scholar 

  8. Hays RD, Morales LS (2001) The RAND-36 measure of health-related quality of life. Ann Med;33:350–7.

    Article  PubMed  CAS  Google Scholar 

  9. McHorney C, Ware JJ, Lu J, Sherbourne C (1994) The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32:40–66.

    Article  PubMed  CAS  Google Scholar 

  10. Miettinen TA, Huttunen JK, Naukkarinen V, et al (1985) Multifactorial primary prevention of cardiovascular diseases in middle-aged men: risk factor changes, incidence and mortality. JAMA 254:2097–2102

    Article  PubMed  CAS  Google Scholar 

  11. Strandberg TE, Strandberg AY, Salomaa VV, et al (2009) Explaining the obesity paradox: cardiovascular risk, weight change, and mortality during long-term followup in men. Eur Heart J 30:1720–1727.

    Article  PubMed  Google Scholar 

  12. Aalto A, Aro A, Teperi J. RAND-36 as a measure of Health-Related Quality of Life. Reliability, construct validity and reference values in the Finnish general population. Helsinki: Stakes, Research Reports 101, 1999

    Google Scholar 

  13. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis 40:373–83.

    Article  PubMed  CAS  Google Scholar 

  14. Syddall HE, Martin HJ, Harwood RH, Cooper C, Sayer AA (2009) The SF-36: A simple, effective measure of mobility-disability for epidemiological studies. J Nutr Health Aging 13:57–62

    Article  PubMed  CAS  Google Scholar 

  15. Gupta AK, Dahlof B, Sever PS, et al (2010) Metabolic syndrome, independent of its components, is a risk factor for stroke and death, but not for coronaRy heart disease among hypertensive patients in the ASCOT-BPLA. Diabetes Care 33:1647–1651

    Article  PubMed  Google Scholar 

  16. Gill TM, Gahbauer EA, Allore HG, Han L (2006) Transitions between frailty states among community-living older persons. Arch Intern Med 166:418–423

    Article  PubMed  Google Scholar 

  17. Rochat S, Cumming RG, Blyth F, et al (2010) Frailty and use of health and community services by community-dwelling older men: the Concord Health and Ageing in Men Project. Age Ageing, ePub

  18. Abellan van Kan G, Rolland Y, Andrieu S, et al (2009) Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people. An International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging 13:881–889

    Article  PubMed  CAS  Google Scholar 

  19. Hubbard R, Searle S, Mitnitski A, Rockwood K (2009) Effect of smoking on the accumulation of deficits, frailty and survival in older adults: A secondary analysis from the Canadian study of health and aging. J Nutr Health Aging;13:468–472.

    Article  PubMed  CAS  Google Scholar 

  20. Dumurgier J, Elbaz A, Ducimetiere P, Tavernier B, Alperovitch A, Tzourio C (2009) Slow walking speed and cardiovascular death in well functioning older adults: prospective cohort study. Br Med J;339:b4460 ePub

    Article  Google Scholar 

  21. Gill TM, Gahbauer EA, Han L, Allore HG (2010) Trajectories of disability in the last year of life. N Engl J Med 362:1173–1180

    Article  PubMed  CAS  Google Scholar 

  22. Rockwood K, Howlett SE, MacKnight C, et al (2004). Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci 59:1310–1317

    Article  PubMed  Google Scholar 

  23. Avila-Funes JA, Amieva H, Barberger-Gateau P, et al (2009) cognitive impairment improves thepredictive validity of the phenotype of frailty for adverse health outcomes: the three-city study. J Am Geriatr Soc 57:453–461

    Article  PubMed  Google Scholar 

  24. Boyle PA, Buchman AS, Wilson RS, Leurgans SE, Bennett DA (2010) Physical frailty is associated with incident mild cognitive impairment in community-based older persons. J Am Geriatr Soc 58:248–255

    Article  PubMed  Google Scholar 

  25. Raji MA, al Snih S, Ostir GV, Markides KS, Ottenbacher KJ (2010) Cognitive status and future risk of frailty in older Mexican Americans. J Geront A Biol Med Sci 65A:1228–1234

    Article  Google Scholar 

  26. Parker SG, Bechinger-English D, Jagger C, Spiers N, Lindesay J (2006) Factors affecting completion of the SF-36 in older people. Age Ageing 35:376–381.

    Article  PubMed  Google Scholar 

  27. Bergmann MM, Jacobs EJ, Hoffmann K, Boeing H (2004) Agreement of selfreported medical history: comparison of an in-person interview with a selfadministered questionnaire. Eur J Epidemiol 19:411–416.

    Article  PubMed  Google Scholar 

  28. Tamakoshi K, Yatsuya H, Kondo T, et al (2003) The accuracy of long-term recall of past body weight in Japanese adult men. Int J Obes Relat Metab Disord 27:247–252

    Article  PubMed  CAS  Google Scholar 

  29. Miller SL, Wolfe RR (2008) The danger of weight loss in the elderly. J Nutr Health Aging. 12(7):487–491

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Timo E. Strandberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sirola, J., Pitkala, K.H., Tilvis, R.S. et al. Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen study. J Nutr Health Aging 15, 783–787 (2011). https://doi.org/10.1007/s12603-011-0131-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-011-0131-4

Key words

Navigation