Highlights
- •Forty percent of subjects without multimorbidity are frail or prefrail.
- •Frailty and pre-frailty increase mortality risk even in absence of multimorbidity.
- •Screening for frailty in individuals without multimorbidity might be beneficial.
- •Future research should focus on causes of frailty other than chronic diseases.
Abstract
Background
Frailty and multimorbidity are both strongly associated with poor health-related outcomes,
including mortality. Being multimorbidity one of the major determinants of frailty,
we aimed to explore whether, and to what extent, frailty without multimorbidity plays
an independent role in shortening life.
Methods
We used data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K).
Among the 3363 adults aged 60+ enrolled at baseline, those without multimorbidity
(i.e.: less than two chronic diseases) (N = 1115) have been characterized according
to Fried's frailty phenotype (i.e. robust, prefrail, and frail). The association between
frailty and mortality was estimated using piecewise proportional hazard regression
models in three five-year time periods.
Results
Among participants without multimorbidity, 424 (38%) were prefrail and 19 (2%) were
frail. During the 15-year follow-up, 263 (24%) participants died: 19%, 29%, and 63%
of those who were robust, prefrail, and frail at baseline, respectively. Within the
first 5 years of follow-up, prefrail and frail participants had more than doubled
mortality risk in comparison to robust ones (HR for pre-frailty 2.08, 95% CI 1.15–3.76;
HR for frailty 2.69, 95% CI 1.22–5.97). Beyond 5 years, a trend of increased mortality
rate was still detectable for prefrail and frail subjects in comparison to robust
ones.
Conclusions
Physical frailty and pre-frailty are associated with short-term mortality in a cohort
of older adults free from multimorbidity. Frailty could be a clinical indicator of
increased risk of negative health outcomes even among subjects without multiple chronic
conditions.
Keywords
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Article info
Publication history
Published online: June 24, 2018
Accepted:
June 13,
2018
Received in revised form:
June 10,
2018
Received:
May 6,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
