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Phase Angle, Frailty and Mortality in Older Adults

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A Capsule Commentary to this article was published on 08 October 2013

ABSTRACT

BACKGROUND

Frailty is a multidimensional phenotype that describes declining physical function and a vulnerability to adverse outcomes in the setting of physical stress such as illness or hospitalization. Phase angle is a composite measure of tissue resistance and reactance measured via bioelectrical impedance analysis (BIA). Whether phase angle is associated with frailty and mortality in the general population is unknown.

OBJECTIVE

To evaluate associations among phase angle, frailty and mortality.

DESIGN

Population-based survey.

SETTING

Third National Health and Nutritional Examination Survey (1988–1994).

PARTICIPANTS

In all, 4,667 persons aged 60 and older.

MEASUREMENTS

Frailty was defined according to a set of criteria derived from a definition previously described and validated.

RESULTS

Narrow phase angle (the lowest quintile) was associated with a four-fold higher odds of frailty among women and a three-fold higher odds of frailty among men, adjusted for age, sex, race-ethnicity and comorbidity. Over a 12-year follow-up period, the adjusted relative hazard for mortality associated with narrow phase angle was 2.4 (95 % confidence interval [95 % CI] 1.8 to 3.1) in women and 2.2 (95 % CI 1.7 to 2.9) in men. Narrow phase angle was significantly associated with mortality even among participants with little or no comorbidity.

LIMITATIONS

Analyses of BIA and frailty were cross-sectional; BIA was not measured serially and incident frailty during follow-up was not assessed. Participants examined at home were excluded from analysis because they did not undergo BIA.

CONCLUSIONS

Narrow phase angle is associated with frailty and mortality independent of age and comorbidity.

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Acknowledgments

Support for Dr. Wilhelm-Leen was provided by a Medical Scholars grant from the Stanford University School of Medicine. Dr. Chertow was supported by K24 DK085446.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Author information

Authors and Affiliations

  1. Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA

    Emilee R. Wilhelm-Leen MD, Ralph I. Horwitz MD & Glenn M. Chertow MD, MPH

  2. Division of Nephrology, Department of Medicine and Kidney Research Institute, University of Washington, Seattle, WA, USA

    Yoshio N. Hall MD

  3. Department of Internal Medicine, Division of Nephrology, Stanford University School of Medicine, 780 Welch Road, Suite 106, Palo Alto, CA, 94304, USA

    Emilee R. Wilhelm-Leen MD & Glenn M. Chertow MD, MPH

Authors
  1. Emilee R. Wilhelm-Leen MD
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  2. Yoshio N. Hall MD
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  3. Ralph I. Horwitz MD
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  4. Glenn M. Chertow MD, MPH
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Corresponding author

Correspondence to Emilee R. Wilhelm-Leen MD.

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Wilhelm-Leen, E.R., Hall, Y.N., Horwitz, R.I. et al. Phase Angle, Frailty and Mortality in Older Adults. J GEN INTERN MED 29, 147–154 (2014). https://doi.org/10.1007/s11606-013-2585-z

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  • DOI: https://doi.org/10.1007/s11606-013-2585-z

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