Frailty transition and burden on mortality risk in middle-aged and older population: a prospective cohort study

• Published in: Scientific reports 2024-11, Vol.14 (1), p.26498-10, Article 26498
• Main Authors: Son, Mi Kyoung, Lee, Kyoungho
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/700/478; Aged; Aged, 80 and over; Aging; Cause of Death; Death; Epidemiology; Female; Frail Elderly - statistics & numerical data; Frailty; Frailty - mortality; Frailty burden; Frailty transition; Geriatric Assessment; Health risks; Humanities and Social Sciences; Humans; Life expectancy; Life span; Male; Middle Aged; Mortality; Mortality - trends; Mortality risk; multidisciplinary; Osteoporosis; Population studies; Preventable deaths; Proportional Hazards Models; Prospective Studies; Republic of Korea - epidemiology; Risk Factors; Science; Science (multidisciplinary)
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-78312-7

The effect of frailty transition and burden on the risk of all-cause mortality in South Korea remains unclear. This study aimed to investigate the risk of all-cause mortality using the most recent frailty index (FI), changes in FI, and frailty burden. We analyzed data from the Korean Genome and Epidemiology Study (2013–2020). A total of 3,134 participants aged 53–87 years with a computable FI based on the osteoporotic fracture index during their initial visit. The FI was updated biennially during re-examinations and changes between the initial and last visits were categorized into four groups: (1) improved or maintained to non-frail, (2) worsened to pre-frail, (3) improved or maintained to pre-frail, and (4) worsened or maintained to frail. We used the Cox proportional hazards model, adjusted for age, sex, education, lifestyle factors, and diseases. During the follow-up, 218 participants died. Compared to those who were robust at the last visit, pre-frailty and frailty were associated with an increased risk of all-cause death. Of those who visited > 2 times, 62.3% improved or remained robust, and had a decreased risk of all-cause death. Those with > 63% of pre-frailty or frailty burden significantly higher risk of death, with > 60% increase compared to their non-frail counterparts. Maintaining or achieving robustness is associated with a decreased risk of mortality. To prevent premature death and extend healthy life expectancy, identifying biological aging through surrogate measures and implementing interventions to maintain or achieve a robust health status are needed.