Trajectories of frailty in aging: Prospective cohort study.

<h4>Background</h4>Emerging evidence suggests that there is significant variability in the progression of frailty in aging. We aimed to identify latent subpopulations of frailty trajectories, and examine their clinical and biological correlates.<h4>Methods</h4>We characterize...

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Autores principales:	Joe Verghese, Emmeline Ayers, Sanish Sathyan, Richard B Lipton, Sofiya Milman, Nir Barzilai, Cuiling Wang
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dca223f3ec124f8e8a390f85dd999682
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spelling	oai:doaj.org-article:dca223f3ec124f8e8a390f85dd9996822021-12-02T20:09:17ZTrajectories of frailty in aging: Prospective cohort study.1932-620310.1371/journal.pone.0253976https://doaj.org/article/dca223f3ec124f8e8a390f85dd9996822021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253976https://doaj.org/toc/1932-6203<h4>Background</h4>Emerging evidence suggests that there is significant variability in the progression of frailty in aging. We aimed to identify latent subpopulations of frailty trajectories, and examine their clinical and biological correlates.<h4>Methods</h4>We characterized frailty using a 41-item cumulative deficit score at baseline and annual visits up to 12 years in 681 older adults (55% women, mean age 74·6 years). Clinical risk profile and walking while talking performance as a clinical marker of trajectories were examined. Mortality risk associated with trajectories was evaluated using Cox regression adjusted for established survival predictors, and reported as hazard ratios (HR). Proteome-wide analysis was done.<h4>Findings</h4>Latent class modeling identified 4 distinct frailty trajectories: relatively stable (34·4%) as well as mild (36·1%), moderate (24·1%) and severely frail (5·4%). Four distinct classes of frailty trajectories were also shown in an independent sample of 515 older adults (60% women, 68% White, 26% Black). The stable group took a median of 31 months to accumulate one additional deficit compared to 20 months in the severely frail group. The worst trajectories were associated with modifiable risk factors such as low education, living alone, obesity, and physical inactivity as well as slower walking while talking speed. In the pooled sample, mild (HR 2·33, 95% CI 1·30-4·18), moderate (HR 2·49, 95% CI 1·33-4·66), and severely frail trajectories (HR 5·28, 95% CI 2·68-10·41) had higher mortality compared to the stable group. Proteomic analysis showed 11 proteins in lipid metabolism and growth factor pathways associated with frailty trajectories.<h4>Conclusion</h4>Frailty shows both stable and accelerated patterns in aging, which can be distinguished clinically and biologically.Joe VergheseEmmeline AyersSanish SathyanRichard B LiptonSofiya MilmanNir BarzilaiCuiling WangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253976 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joe Verghese Emmeline Ayers Sanish Sathyan Richard B Lipton Sofiya Milman Nir Barzilai Cuiling Wang Trajectories of frailty in aging: Prospective cohort study.
description	<h4>Background</h4>Emerging evidence suggests that there is significant variability in the progression of frailty in aging. We aimed to identify latent subpopulations of frailty trajectories, and examine their clinical and biological correlates.<h4>Methods</h4>We characterized frailty using a 41-item cumulative deficit score at baseline and annual visits up to 12 years in 681 older adults (55% women, mean age 74·6 years). Clinical risk profile and walking while talking performance as a clinical marker of trajectories were examined. Mortality risk associated with trajectories was evaluated using Cox regression adjusted for established survival predictors, and reported as hazard ratios (HR). Proteome-wide analysis was done.<h4>Findings</h4>Latent class modeling identified 4 distinct frailty trajectories: relatively stable (34·4%) as well as mild (36·1%), moderate (24·1%) and severely frail (5·4%). Four distinct classes of frailty trajectories were also shown in an independent sample of 515 older adults (60% women, 68% White, 26% Black). The stable group took a median of 31 months to accumulate one additional deficit compared to 20 months in the severely frail group. The worst trajectories were associated with modifiable risk factors such as low education, living alone, obesity, and physical inactivity as well as slower walking while talking speed. In the pooled sample, mild (HR 2·33, 95% CI 1·30-4·18), moderate (HR 2·49, 95% CI 1·33-4·66), and severely frail trajectories (HR 5·28, 95% CI 2·68-10·41) had higher mortality compared to the stable group. Proteomic analysis showed 11 proteins in lipid metabolism and growth factor pathways associated with frailty trajectories.<h4>Conclusion</h4>Frailty shows both stable and accelerated patterns in aging, which can be distinguished clinically and biologically.
format	article
author	Joe Verghese Emmeline Ayers Sanish Sathyan Richard B Lipton Sofiya Milman Nir Barzilai Cuiling Wang
author_facet	Joe Verghese Emmeline Ayers Sanish Sathyan Richard B Lipton Sofiya Milman Nir Barzilai Cuiling Wang
author_sort	Joe Verghese
title	Trajectories of frailty in aging: Prospective cohort study.
title_short	Trajectories of frailty in aging: Prospective cohort study.
title_full	Trajectories of frailty in aging: Prospective cohort study.
title_fullStr	Trajectories of frailty in aging: Prospective cohort study.
title_full_unstemmed	Trajectories of frailty in aging: Prospective cohort study.
title_sort	trajectories of frailty in aging: prospective cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/dca223f3ec124f8e8a390f85dd999682
work_keys_str_mv	AT joeverghese trajectoriesoffrailtyinagingprospectivecohortstudy AT emmelineayers trajectoriesoffrailtyinagingprospectivecohortstudy AT sanishsathyan trajectoriesoffrailtyinagingprospectivecohortstudy AT richardblipton trajectoriesoffrailtyinagingprospectivecohortstudy AT sofiyamilman trajectoriesoffrailtyinagingprospectivecohortstudy AT nirbarzilai trajectoriesoffrailtyinagingprospectivecohortstudy AT cuilingwang trajectoriesoffrailtyinagingprospectivecohortstudy
_version_	1718375092673576960

Trajectories of frailty in aging: Prospective cohort study.

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