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Lecture 2: Disability and frailty
Compression of morbidity and mortality hypotheses
PNAS 2001 98: 6354-6359
PNAS 2001 98: 6354-6359
PNAS 2001 98: 6354-6359
N. Engl. J. Med. 2006; 355: 695 - 703.
N. Engl. J. Med. 2006; 355: 695 - 703.
Frailty: the next stage of chronic disease?
Hospitalization, Restricted Activity, and the Development of Disability Among Older Persons
• Cohort– March 1998 and October 1999– potential participants were identified from a computerized list of 3157
age-eligible members from a large health plan in greater New Haven– screening telephone interview – in-home assessment.
• Physical frailty– Timed score of greater than 10 seconds on the rapid gait test (ie, walk
back and forth over a 10-ft [3-m] course as quickly as possible)– In the absence of a criterion standard, operationalizing physical frailty as
slow gait speed is justified by:• High face validity• Clinical feasibility• Strong epidemiological link to functional decline and disability
JAMA. 2004;292:2115-2124
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Gill, T. M. et al. JAMA 2004;292:2115-2124.
Baseline Characteristics of Study Participants*
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Gill, T. M. et al. JAMA 2004;292:2115-2124.
Kaplan-Meier Curves for the Development of Disability
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Gill, T. M. et al. JAMA 2004;292:2115-2124.
Exposure to Intervening Events per 100 Months According to Disability Status*
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Gill, T. M. et al. JAMA 2004;292:2115-2124.
Factors Associated With the Development of Any Disability*
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Gill, T. M. et al. JAMA 2004;292:2115-2124.
Association Between New Intervening Events and Disability According to Physical Frailty at Baseline
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Gill, T. M. et al. Arch Intern Med 2006;166:418-423.
Numbers and Rates of Transitions From Prefrail State at 18 Months to Subsequent State at 36 Months According to Baseline State*
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