Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men The Helsinki Businessmen Study (HBS)

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Strandberg , T E , Lindström , L , Jyväkorpi , S , Urtamo , A , Pitkälä , K H & Kivimäki , M 2021 , ' Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men The Helsinki Businessmen Study (HBS) ' , European Geriatric Medicine , vol. 12 , no. 5 , pp. 953-961 . https://doi.org/10.1007/s41999-021-00472-w

Title: Phenotypic frailty and multimorbidity are independent 18-year mortality risk indicators in older men The Helsinki Businessmen Study (HBS)
Author: Strandberg, Timo E.; Lindström, Linda; Jyväkorpi, Satu; Urtamo, Annele; Pitkälä, Kaisu H.; Kivimäki, Mika
Contributor organization: HUS Internal Medicine and Rehabilitation
Timo Strandberg / Principal Investigator
Department of Medicine
Clinicum
Department of General Practice and Primary Health Care
University of Helsinki
Teachers' Academy
Helsinki University Hospital Area
Date: 2021-10
Language: eng
Number of pages: 9
Belongs to series: European Geriatric Medicine
ISSN: 1878-7649
DOI: https://doi.org/10.1007/s41999-021-00472-w
URI: http://hdl.handle.net/10138/340317
Abstract: Purpose Multimorbidity, prefrailty, and frailty are frequent in ageing populations, but their independent relationships to long-term prognosis in home-dwelling older people are not well recognised. Methods In the Helsinki Businessmen Study (HBS) men with high socioeconomic status (born 1919-1934, n = 3490) have been followed-up from midlife. In 2000, multimorbidity (>= 2 conditions), phenotypic prefrailty and frailty were determined in 1365 home-dwelling men with median age of 73 years). Disability was assessed as a possible confounder. 18-year mortality follow-up was established from registers and Cox regression used for analyses. Results Of the men, 433 (31.7%) were nonfrail and without multimorbidity at baseline (reference group), 500 (36.6%) and 82 (6.0%) men had prefrailty or frailty, respectively, without multimorbidity, 84 (6.2%) men had multimorbidity only, and 201 (14.7%) and 65 (4.8%) men had prefrailty or frailty together with multimorbidity. Only 30 (2.2%) and 86 (6.3%) showed signs of ADL or mobility disability. In the fully adjusted analyses (including ADL disability, mental and cognitive status) of 18-year mortality, frailty without multimorbidity (hazard ratio 1.62, 95% confidence interval 1.13-2.31) was associated with similar mortality risk than multimorbidity without frailty (1.55, 1.17-2.06). The presence of both frailty and multimorbidity indicated a strong mortality risk (2.93, 2.10-4.07). Conclusion Although multimorbidity is generally considered a substantial health problem, our long-term observational study emphasises that phenotypic frailty alone, independently of disability, may be associated with a similar risk, and a combination of multimorbidity and frailty is an especially strong predictor of mortality. Key summary pointsObjective Multimorbidity, phenotypic prefrailty and frailty are frequent in ageing populations Findings This long-term follow-up of home-dwelling older men reveals the relationship of phenotypic frailty to long-term prognosis, independently of the presence of significant chronic diseases and disability. Message Assessment of phenotypic frailty and already prefrailty provides extra clinical value for the assessment of prognosis in old age.
Subject: Disability
Frailty
Mortality
Multimorbidity
Prefrailty
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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