Erwin Stolz, Anna Schultz, Emiel O Hoogendijk, Olga Theou, Kenneth Rockwood
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We calculated the intraindividual standard deviation of the FI and used location-scale mixed regression models.</p><p><strong>Results: </strong>Mean intraindividual standard deviation was 0.04 (standard deviation = .03). Fluctuations were driven foremost by cognitive problems, somatic symptoms, and limitations in instrumental and mobility-related activities of daily living. Short-term fluctuations correlated with higher FI levels (r = 0.62), 1-year FI change (r = 0.26), and older age (+3% per year). Older adults who took to bed due to a health problem (+50%), those who had an overnight hospital stay (+50%), and those who died during follow-up (+44%) exhibited more FI fluctuations.</p><p><strong>Conclusions: </strong>Short-term FI fluctuations were neither small nor random. Instead, as older adults become frailer, their measured health also becomes more unstable; hence, short-term fluctuations in overall health status can be seen as a concomitant phenomenon of the aging process. Researchers and clinicians should be aware of the existence of reversible fluctuations in the FI over weeks and months and its consequences for frailty monitoring.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632230/pdf/","citationCount":"0","resultStr":"{\"title\":\"Short-term Frailty Index Fluctuations in Older Adults: Noise or Signal?\",\"authors\":\"Erwin Stolz, Anna Schultz, Emiel O Hoogendijk, Olga Theou, Kenneth Rockwood\",\"doi\":\"10.1093/gerona/glae262\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Reversible short-term fluctuations in the frailty index (FI) are often thought of as representing only noise or error. 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Short-term fluctuations correlated with higher FI levels (r = 0.62), 1-year FI change (r = 0.26), and older age (+3% per year). Older adults who took to bed due to a health problem (+50%), those who had an overnight hospital stay (+50%), and those who died during follow-up (+44%) exhibited more FI fluctuations.</p><p><strong>Conclusions: </strong>Short-term FI fluctuations were neither small nor random. Instead, as older adults become frailer, their measured health also becomes more unstable; hence, short-term fluctuations in overall health status can be seen as a concomitant phenomenon of the aging process. Researchers and clinicians should be aware of the existence of reversible fluctuations in the FI over weeks and months and its consequences for frailty monitoring.</p>\",\"PeriodicalId\":94243,\"journal\":{\"name\":\"The journals of gerontology. 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引用次数: 0
摘要
背景:人们通常认为虚弱指数(FI)的可逆短期波动仅代表噪音或误差。在此,我们将评估:(1) 短期虚弱指数波动的大小和来源;(2) 不同社会人口统计学之间的差异;(3) 与慢性疾病的关联;(4) 与年龄、虚弱程度、虚弱变化和死亡率的相关性;(5) 波动是否反映了离散的健康转变:晚年健康评估(FRAIL70+)研究采用测量突发设计(5122 次重复观察,中位数为每人 13 次重复观察),收集了来自 426 名社区老年人(70 岁以上)的全国性双周纵向数据。我们计算了 FI 的个体内标准偏差 (iSD),并使用了位置尺度混合回归模型:平均 iSD 为 0.04(SD=0.03)。波动的主要原因是认知问题、躯体症状以及工具性和活动性日常生活活动的限制。短期波动与较高的 FI 水平(r=0.62)、一年的 FI 变化(r=0.26)和年龄(每年 +3%)相关。因健康问题而卧床的老年人(+50%)、住院过夜的老年人(+50%)以及在随访期间死亡的老年人(+44%)的FI波动更大:短期 FI 波动既不小,也不是随机的。因此,整体健康状态的短期波动可被视为衰老过程中的一种伴随现象。研究人员和临床医生应该意识到 FI 在数周或数月内的可逆波动及其对虚弱监测的影响。
Short-term Frailty Index Fluctuations in Older Adults: Noise or Signal?
Background: Reversible short-term fluctuations in the frailty index (FI) are often thought of as representing only noise or error. Here, we assess (i) the size and source of short-term FI fluctuations, (ii) variation across sociodemographic characteristics, (iii) association with chronic diseases, (iv) correlation with age, frailty level, frailty change, and mortality, and (v) whether fluctuations reflect discrete health transitions.
Methods: Nationwide, biweekly longitudinal data from 426 community-dwelling older adults (70+) were collected in the FRequent health Assessment In Later life (FRAIL70+) study using a measurement burst design (5 122 repeated observations, median of 13 repeated observations per person). We calculated the intraindividual standard deviation of the FI and used location-scale mixed regression models.
Results: Mean intraindividual standard deviation was 0.04 (standard deviation = .03). Fluctuations were driven foremost by cognitive problems, somatic symptoms, and limitations in instrumental and mobility-related activities of daily living. Short-term fluctuations correlated with higher FI levels (r = 0.62), 1-year FI change (r = 0.26), and older age (+3% per year). Older adults who took to bed due to a health problem (+50%), those who had an overnight hospital stay (+50%), and those who died during follow-up (+44%) exhibited more FI fluctuations.
Conclusions: Short-term FI fluctuations were neither small nor random. Instead, as older adults become frailer, their measured health also becomes more unstable; hence, short-term fluctuations in overall health status can be seen as a concomitant phenomenon of the aging process. Researchers and clinicians should be aware of the existence of reversible fluctuations in the FI over weeks and months and its consequences for frailty monitoring.