Association between frailty and major chronic disease-free life expectancy: a large community-based longitudinal study.

Abstract

Objectives: We aimed to investigate the extent to which frailty is associated with chronic disease-free life expectancy (LE), focusing on major chronic diseases such as cardiovascular disease [CVD], diabetes, dementia, and cancer, in both males and females.

Methods: Within the UK Biobank, 392,982 chronic disease-free participants (mean age: 55.8 ± 8.1 years; 55.1% female) were followed for up to 16 years. Frailty at baseline was assessed based on five criteria: self-reported weight loss, exhaustion, low physical activity, slow walking speed, and poor grip strength. All participants were categorized as non-frail (0 criteria), pre-frail (1-2 criteria), and frail (≥3 criteria). CVD, diabetes, dementia, cancer, and death were ascertained through medical records and the death registry. Data were analyzed using parametric proportional hazard regression models with a Gompertz distribution in a multi-state context.

Results: At baseline, there were 113,421 (64.3%), 59,553 (33.7%), and 3,516 (2.0%) non-frail, pre-frail, and frail males, respectively, and 125,285 (57.9%), 83,935 (38.8%), and 7,272 (3.3%) corresponding females. At age 50, the estimated chronic disease-free LE (95% confidence interval) for non-frail, pre-frail, and frail males were 20.64 (20.31, 21.01), 18.73 (18.41, 19.13), and 14.75 (14.40, 15.20), with corresponding LE for females of 25.77 (25.34, 26.15), 23.65 (23.22, 24.07), and 19.15 (18.70, 19.67). Respectively, chronic disease-free LE was 5.90 (3.95, 7.84) and 6.62 (4.47, 8.77) years shorter for males and females who were frail compared to non-frail.

Conclusion: Frailty is associated with more than 5 years shorter chronic disease-free LE in both males and females.