Cumulative index of health disorders as an indicator of aging-associated processes in the elderly: Results from analyses of the National Long Term Care Survey
Open accessAbstract
Background We employ an approach based on the elaborated frailty index (FI), which is capable of taking into account variables with mild effect on the aging, health and survival outcomes, and investigate the connections between the FI, chronological age and the aging-associated outcomes in the elderly.Methods Cross-sectional analysis of pooled data from the National Long Term Care Survey (NLTCS) assessing health and functioning of the U.S. elderly in 1982, 1984, 1989, 1994, and 1999.Results Distributions of frequency, residual life span, mortality rate, and relative risk of death are remarkably similar over age and FI. Coefficients of correlation between FI and age are low both for males (0.127, p<.01) and females (0.221, p<.01). The FI-specific age patterns show deceleration at advanced ages. The FI can provide order of magnitude better resolution in estimating mean remaining life span compared to age. Males have smaller FI than females while males' mortality risks are higher. For short-time horizons, the FI and age are largely independently associated with mortality risks.Conclusions The FI: (i) can be considered as an adequate sex-specific indicator of the aging-associated processes in the elderly, (ii) can characterize these processes independently of age, and (iii) is a better characteristic of the aging phenotype than chronological age.
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In each study, the frailer the person is (the higher the deficit count) the more vulnerable they are to adverse outcomes.
“In each study, the frailer the person is (the higher the deficit count) the more vulnerable they are to adverse outcomes [5,8,11].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
The results yielded by the frailty index have been consistent between surveys evaluated by our group and by others even though not every frailty index considers the same deficits or number of deficits.
“the results yielded by the frailty index have been consistent between surveys evaluated by our group [4-7] and by others [8-11] even though not every frailty index considers the same deficits, or even the same number of deficits.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
Acceleration of deficit accumulation is characteristic of older people prior to death.
“In addition, acceleration of deficit accumulation is characteristic of older people prior to death [8].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
Mortality exponentially increases with the accumulation of deficits.
“mortality exponentially increases with the accumulation of deficits [5,8,19].”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
It does not matter if study A considered 40 deficits from set X and study B considered 60 deficits from set Y; the estimates from each (e.g. rate of deficit accumulation, relationship with mortality, limit) appear to be similar.
“it does not matter if study A considered 40 deficits from set X of deficits and study B considered 60 deficits from set Y of deficits; the estimates from each (e.g. the rate of deficit accumulation, the relationship between deficit accumulation and mortality, or the limit to deficit accumulation) appear to be similar.”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
The value 0.2 on the frailty index is recognized by multiple frailty measures as approaching a frail state.
“The value 0.2 on the frailty index is recognized by multiple frailty measures as approaching a frail state [7,8,22]”
From A standard procedure for creating a frailty index (2008) · cites this paper as [8]
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- Authors
- Kulminski, A., Yashin, A., Arbeev, K., Akushevich, I., Ukraintseva, S., Land, K., & Manton, K.
- Affiliations
- Duke University (US)
- Corresponding author
- Kulminski, A.
- Venue
- Mechanisms of Ageing and Development
- Publisher
- Elsevier BV
- Published
- 2007-03
- Volume
- 128
- Issue
- 3
- Pages
- 250-258
- ISSN
- 0047-6374 (ISSN-L)
- PMC
- PMC1866299
- OpenAlex
- W2039868002
- Cited by
- 132
- References
- 36
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 13 · 2023: 8 · 2022: 6 · 2021: 9 · 2020: 8 · 2019: 3 · 2018: 8 · 2017: 6 · 2016: 13 · 2015: 6 · 2014: 8 · 2013: 4 · 2012: 2
- FWCI
- 4.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Mechanisms of Ageing and Development (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P01AG008761, R01AG027019, R01AG028259, U01AG007198, K12AG000982, K12-AG-000982-05, P30AG034424)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R03HD050374)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- frailty index, aging, older adults, mortality risk, sex differences, aging phenotypes, National Long Term Care Survey
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Data Interpretation, Statistical, Female, Health Status Indicators, Humans, Male, Middle Aged, Mortality, Surveys and Questionnaires, Risk, Sex Factors, United States, Logistic Models, Proportional Hazards Models, Health Care Surveys
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