Disability and frailty

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

Copyright restrictions may apply.

Gill, T. M. et al. JAMA 2004;292:2115-2124.

Baseline Characteristics of Study Participants*


Gill, T. M. et al. JAMA 2004;292:2115-2124.

Kaplan-Meier Curves for the Development of Disability


Gill, T. M. et al. JAMA 2004;292:2115-2124.

Exposure to Intervening Events per 100 Months According to Disability Status*


Gill, T. M. et al. JAMA 2004;292:2115-2124.

Factors Associated With the Development of Any Disability*


Gill, T. M. et al. JAMA 2004;292:2115-2124.

Association Between New Intervening Events and Disability According to Physical Frailty at Baseline


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*

Education

Disability and frailty