Predictors of Frailty Transitions in Mexican Older Adults.

Ana Rivera-Almaraz, Aarón Salinas-Rodríguez, Eduardo Gutiérrez-Peña, Betty Soledad Manrique-Espinoza
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Abstract

Background: Frailty is a dynamic state in older adults. Current evidence, mostly in high-income countries, found that improving frailty is more likely in mild states (prefrailty). We aimed to determine the probability of frailty transitions and their predictors.

Methods: Participants were adults aged 50 years or over from the Study on Global Ageing and Adult Health in Mexico during 4 waves (2009, 2014, 2017, and 2021). We defined frailty with the frailty phenotype and we used multinomial logistic models to estimate the probabilities of frailty transitions and determine their predictors.

Results: For the 3 analyzed periods (2009-2014, 2014-2017, and 2017-2021), transition probabilities from frail to robust were higher for the younger age group (50-59 years) at 0.20, 0.26, and 0.20, and lower for the older age group (≥80 years), 0.03, 0.08 and 0.04. Transitioning from prefrail to robust had probabilities of 0.38, 0.37, and 0.35, for the younger age group, and 0.09, 0.18, and 0.10, for the older age group. The probabilities of transitioning to frail and to death were lower for the younger age group and for the robust at baseline; but higher for the older age group and for the frail at baseline. We identified age, disability, and diabetes as the most significant predictors of frailty transitions.

Conclusions: These findings show that frailty has a dynamic nature and that a significant proportion of prefrail and frail individuals can recover to a robust or prefrail state. They also emphasize that prefrailty should be the focus of interventions.

墨西哥老年人体弱转变的预测因素。
背景:虚弱是老年人的一种动态状态。目前主要在高收入国家发现的证据表明,在轻度虚弱状态(虚弱前期)下更有可能改善虚弱状况。我们旨在确定虚弱转变的概率及其预测因素:参与者为墨西哥全球老龄化和成人健康研究中 50 岁或以上的成年人,共进行了 4 次研究(2009 年、2014 年、2017 年和 2021 年)。我们用虚弱表型来定义虚弱,并使用多叉逻辑模型来估计虚弱转变的概率并确定其预测因素:在所分析的三个时期(2009-2014 年、2014-2017 年和 2017-2021 年),年轻年龄组(50-59 岁)从虚弱过渡到健壮的概率较高,分别为 0.20、0.26 和 0.20,而老年年龄组(≥80 岁)则较低,分别为 0.03、0.08 和 0.04。在年轻组中,从轻度残疾过渡到重度残疾的概率分别为 0.38、0.37 和 0.35;在老年组中,从轻度残疾过渡到重度残疾的概率分别为 0.09、0.18 和 0.10。基线时,年轻组和健壮组过渡到体弱和死亡的概率较低;但基线时,老年组和体弱组过渡到体弱和死亡的概率较高。我们发现,年龄、残疾和糖尿病是预测虚弱转变的最重要因素:这些研究结果表明,虚弱具有动态性,相当一部分虚弱前和虚弱的人可以恢复到健壮或虚弱前的状态。结论:这些研究结果表明,虚弱具有动态性,相当一部分体弱前期和体弱者可以恢复到健壮或体弱前期状态,这些研究结果还强调,体弱前期应成为干预的重点。
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